Individual
SANDRA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9 HANOVER ST, SUITE 2, LEBANON, NH 03766-1312
(603) 448-0126
Mailing address
140 NORTH ST, CLAREMONT, NH 03743-2038
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
045866-21
NH
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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