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Individual

JOSHUA WAGENKNECHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1001 BELLEFONTAINE AVE, LIMA, OH 45804-2800
(419) 291-3627
Mailing address
411 E MCCREIGHT AVE, SPRINGFIELD, OH 45503-3631
(419) 346-1016

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004131
OH

Other

Enumeration date
10/17/2014
Last updated
10/17/2014
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