Individual
EMILY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
128 JACKSON ST, BROOKLYN, IA 52211-7711
(641) 522-7221
Mailing address
128 JACKSON ST, BROOKLYN, IA 52211-7711
(641) 522-7221
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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