T W Wagner INC

NPI #1548244171 in Manila, Arkansas

Provider Information

NPI Number
1548244171
Entity Type
Organization
Organization Name
T W Wagner INC
Primary Specialty
Clinic/Center - Rural Health
Enumeration Date
Dec 6, 2005
Last Updated
Jul 22, 2016

Practice Location

Address
3644 W STATE HIGHWAY 18
City
Manila
ZIP Code
72442-8049
Phone
(870) 561-3300

Authorized Official

Name
TOMMY W WAGNER JR., M.D.
Title
OWNER
Phone
(870) 561-3300

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Rural HealthRural Health

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