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Individual

DR. JENNIFER L WAGNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
2035 COMMERCE DR STE 208, BLUFFTON, IN 46714-9295
(260) 706-2558
(260) 435-1595
Mailing address
2035 COMMERCE DR STE 208, BLUFFTON, IN 46714-9295
(260) 706-2558

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002421A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200874560
IN
Enumeration date
09/06/2007
Last updated
10/15/2020
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