Laura Wagner INC

NPI #1194956276 in Town and Country, Missouri

Provider Information

NPI Number: 1194956276
Entity Type: Organization
Organization Name: Laura Wagner INC
Primary Specialty: Dermatology
Enumeration Date: Aug 6, 2009
Last Updated: Nov 28, 2012

Practice Location

Address: 14377 WOODLAKE DR
Address 2: SUITE 111
City: Town and Country
State: Missouri
ZIP Code: 63017-5735
Phone: (314) 434-1111

Authorized Official

Name: DR. LAURA WAGNER, M.D.
Title: PRESIDENT
Phone: (314) 434-1111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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