Individual
DEBRA WAGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1249 CHARLES ST, LOGAN, OH 43138-9713
(740) 603-6186
Mailing address
1249 CHARLES ST, LOGAN, OH 43138-9713
(740) 603-6186
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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