Individual
RYAN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
301 W 15TH ST, CHESTER, PA 19013-5300
(610) 619-8767
Mailing address
301 W 15TH ST, CHESTER, PA 19013-5300
(610) 619-8767
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/12/2020
Last updated
05/12/2020
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