Individual
MR. GARY M WAGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L. AC.
Contact information
Practice address
21730 WILLAMETTE DR, WEST LINN, OR 97068-3257
(503) 636-1823
Mailing address
21730 WILLAMETTE DR, WEST LINN, OR 97068-3257
(503) 636-1823
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00714
OR
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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