person
Mr. Paul Brooks Wagner, CCP
Vascular Specialist/Technologist in Modesto, California
NPI 1518063916

Paul Brooks Wagner is a Vascular Specialist/Technologist based in Modesto, CA and is specialized in Vascular Specialist. Paul Brooks Wagner practices in Modesto, CA and has the professional credentials of CCP. The NPI Number for Paul Brooks Wagner is 1518063916 and holds a License No. 890191-0970 (California).

The current practice location address for Paul Brooks Wagner is 1836 Harbor Cv, Modesto, CA and can be reached out via phone at 209-484-8516 and via fax at 209-576-3613. You can also correspond with Paul Brooks Wagner through the mailing address at 1836 HARBOR CV, MODESTO, CA - 95355-1856 (mailing address contact number: 209-484-8516).

Location: 1836 Harbor Cv, Modesto, CA, 95355-1856
person
Provider Profile Details
NPI Number
1518063916
Provider Name
Paul Brooks Wagner
Credential
CCP
Provider Entity Type
Individual
Gender
Male
Address
1836 Harbor Cv, Modesto, CA, 95355-1856
Phone Number
209-484-8516
Fax Number
209-576-3613
Provider Enumeration Date
09/15/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1836 Harbor Cv
City
State
Zip
95355-1856
Phone Number
209-484-8516
Fax Number
209-576-3613
person
Provider Business Mailing Address Details
Address
1836 Harbor Cv
City
State
Zip
95355-1856
Phone Number
209-484-8516
Fax Number
209-576-3613
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Specialist/Technologist Cardiovascular
Speciality
Vascular Specialist
Taxonomy
License No.
890191-0970 (Mississippi)
Definition
Definition to come...
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