Wagner, Marie A

Wagner, Marie A is an sole proprietor health care provider with primary practice located at 365 Sw Log Dr , Port Saint Lucie FL 34953-7501. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Wagner, Marie A can be contacted via phone (772) 785-6473.

Contact Information

Primary practice address
365 Sw Log Dr Port Saint Lucie FL 34953-7501
Phone: (772) 785-6473
Fax: (772) 408-0998
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X 19-3549-004-08 Florida

Profile Details

NPI number 1184895070
LBN Legal business name Wagner, Marie A
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 18th, 2008
Last updated Mar 18th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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