Organization · Type 2 NPI
Wagoner Holdings PA
Health Service Clinic/Center · Wake Forest, NC
NPI number
1679236400
Active
Practice location
851 Wake Forest Business Park Ste E
Wake Forest, NC 27587-7366
Mailing address
1408 Woodland Hills Trl Apt 204
Wake Forest, NC 27587-1778
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Health Service Clinic/Center Primary | 261QH0100X | None listed |
Health Service Clinic/Center: Definition to come...
About NPI 1679236400
Wagoner Holdings PA's National Provider Identifier is 1679236400, issued on Oct 19, 2021. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Wake Forest, NC. The record was last updated on Oct 19, 2021.