Individual provider · Type 1 NPI

Jacob Norman Wagner

Other Technician · Redford, MI

NPI number 1194176784 Active

Practice location

17293 Delaware Ave
Redford, MI 48240-2302

Call (313) 948-7199 Map

Specialties and licenses

TaxonomyCodeLicense
Other Technician Primary 247200000XNone listed

Other Technician: A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

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About NPI 1194176784

Jacob Norman Wagner's National Provider Identifier is 1194176784, issued on Jun 25, 2016. The primary taxonomy on file is Other Technician (247200000X), and the practice location is in Redford, MI. The record was last updated on Jun 25, 2016.