Individual
MRS. LINNAE MERITH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
393 DUNLAP ST N, STE LL34, SAINT PAUL, MN 55104-4200
(651) 644-6002
(651) 647-1647
Mailing address
393 DUNLAP ST N, STE LL34, SAINT PAUL, MN 55104-4200
(651) 644-6002
(651) 647-1647
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6126
MN
Other
Enumeration date
06/29/2006
Last updated
02/21/2013
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