Heather Wagner

NPI #1881931061 in Freeport, Illinois

Provider Information

NPI Number: 1881931061
Entity Type: Individual
Name: Heather Wagner
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Jan 9, 2013
Last Updated: Jan 9, 2013

Practice Location

Address: 421 W EXCHANGE ST
City: Freeport
State: Illinois
ZIP Code: 61032-4008
Phone: (815) 599-7300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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