Individual
BRETT WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8701 W WATERTOWN PLANK RD FL HUB5, MILWAUKEE, WI 53226-3548
(414) 955-6900
(414) 955-0079
Mailing address
836 S 86TH ST, WEST ALLIS, WI 53214-2905
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
226-18
WI
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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