Individual
MOLLY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
136 GRAPEVINE RD, HUNTINGTON, WV 25701-6212
(681) 203-4510
Mailing address
136 GRAPEVINE RD, HUNTINGTON, WV 25701-6212
(681) 203-4510
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/19/2026
Last updated
05/19/2026
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