Individual
MR. BRENTON PAUL WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
12300 MCCRACKEN ROAD, GARFIELD HEIGHTS, OH 44125
(216) 581-0500
Mailing address
540 E PORTAGE TRL APT 310, CUYAHOGA FALLS, OH 44221-2868
(419) 961-4784
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.022596
OH
Other
Enumeration date
05/23/2018
Last updated
02/21/2022
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