Individual
CARSON WAGOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
983 BOSTON-PROVIDENCE TURNPIKE, DEDHAM, MA 02026
(781) 819-6400
Mailing address
131 SEAPORT BLVD APT 1515, BOSTON, MA 02210-3049
(207) 604-0997
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/27/2021
Last updated
11/18/2021
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