Organization
HEART OF AMERICA BARIATRICS LLC
Active
Organization
HEART OF AMERICA BARIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VAN L WAGNER M.D. (OWNER/SOLE PROPRIETOR)
(314) 776-7112
Entity
Organization
Contact information
Practice address
1400 LEMAY FERRY RD, SUITE A, SAINT LOUIS, MO 63125-2417
(314) 776-7112
Mailing address
PO BOX 29255, SAINT LOUIS, MO 63126-0255
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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