Individual
BRANDON WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
335 GLESSNER AVE, MANSFIELD, OH 44903-2269
(419) 528-8328
Mailing address
799 LEXINGTON AVE, MANSFIELD, OH 44907-1906
(419) 756-5133
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0020956
OH
Other
Enumeration date
07/31/2023
Last updated
02/28/2024
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