Individual
THOMAS WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1221 WHIPPLE ST, EAU CLAIRE, WI 54703
(715) 838-5222
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(715) 838-5222
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3538
WI
Other
Enumeration date
06/12/2015
Last updated
08/11/2021
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