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Individual

ALAN WAGNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
795 S TOWNSHIP ROAD 113, TIFFIN, OH 44883-9791
(419) 987-4440
Mailing address
795 S TOWNSHIP ROAD 113, TIFFIN, OH 44883-9791
(419) 987-4440

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
7401270
OH
347C00000X
Private Vehicle
7401270
OH
3747P1801X
Personal Care Attendant
7401270
OH
376J00000X
Homemaker
Primary
7401270
OH
385H00000X
Respite Care
7401270
OH

Other

Enumeration date
10/29/2020
Last updated
10/29/2020
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