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Individual

MRS. AMBER L WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1260 SENTRY DR STE 140, WAUKESHA, WI 53186-5990
(262) 524-1024
(262) 524-8767
Mailing address
1260 SENTRY DR STE 140, WAUKESHA, WI 53186-5990
(262) 524-1024
(262) 524-8767

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3165-23
WI

Other

Enumeration date
07/16/2013
Last updated
12/22/2020
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