Individual
JORDAN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2975 ROSLYN ST, DENVER, CO 80238-3325
(303) 399-7900
Mailing address
1955 ULSTER ST APT 154, DENVER, CO 80220-2059
(720) 323-9642
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.0005058
CO
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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