Individual
MRS. LORETTA ANN WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
8473 LEAVER AVE NW, CANAL FULTON, OH 44614-8871
(330) 854-6597
(330) 854-6597
Mailing address
8473 LEAVER AVE NW, CANAL FULTON, OH 44614-8871
(330) 854-6597
(330) 854-6597
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
501043601105
OH
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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