Individual
MS. MARY E WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2549 ODANIEL RD, SEGUIN, TX 78155-1240
(830) 303-2508
(830) 379-5411
Mailing address
2549 ODANIEL RD, SEGUIN, TX 78155-1240
(830) 303-2508
(830) 379-5411
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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