Individual
MRS. WANDA MARIA WOLFGANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
119 SOUTH AVE, WEBSTER, NY 14580-3559
(585) 216-0059
Mailing address
119 SOUTH AVE, WEBSTER, NY 14580-3559
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
287640
NY
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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