Individual
PETER WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3441 W SAHARA AVE STE C1, LAS VEGAS, NV 89102-6059
(702) 445-7318
Mailing address
3441 W SAHARA AVE STE C1, LAS VEGAS, NV 89102-6059
(702) 445-7318
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
PRSS5282
NV
Other
Enumeration date
03/21/2025
Last updated
03/21/2025
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