Individual
ASHLEY WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6300 N MAIN ST, DAYTON, OH 45415-3154
(937) 275-1500
Mailing address
6300 N MAIN ST, DAYTON, OH 45415-3154
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.143520.MEDS-IV
OH
Other
Enumeration date
06/10/2022
Last updated
06/10/2022
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