Individual
KEVIN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HAS, BC-HIS
Contact information
Practice address
3534 CLARK RD, #132, SARASOTA, FL 34231-8408
(941) 922-6028
Mailing address
3534 CLARK RD, #132, SARASOTA, FL 34231-8408
(941) 922-6028
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
AS2789
FL
Other
Enumeration date
03/25/2015
Last updated
03/25/2015
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