MR. Evan Michael Wagner I, BS

NPI #1518478775 in Port Huron, Michigan

Provider Information

NPI Number: 1518478775
Entity Type: Individual
Name: MR. Evan Michael Wagner I, BS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Health Educator
Credential: BS
Enumeration Date: Oct 16, 2017
Last Updated: Mar 17, 2018

Practice Location

Address: 3111 ELECTRIC AVE
City: Port Huron
State: Michigan
ZIP Code: 48060-8127
Phone: (810) 985-8900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Health Educator	174H00000X	Primary

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