Individual
VICTOR S WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
MECOSTA COUNTY MEDICAL CENTER, 605 OAK STREET, BIG RAPIDS, MI 49307
(231) 592-4444
Mailing address
858 PINECREST AVE SE, GRAND RAPIDS, MI 49506-3435
(616) 719-6208
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301008134
MI
Other
Enumeration date
07/07/2006
Last updated
03/07/2008
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