Individual
CHELSEA JO A WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3201 CHERRY RIDGE ST STE D400, SAN ANTONIO, TX 78230-4820
(210) 692-0222
Mailing address
4900 MEDICAL DR APT 1523, SAN ANTONIO, TX 78229-4333
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
334554
TX
Other
Enumeration date
03/02/2018
Last updated
03/02/2018
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