Roy Marshall Wagner is a student in an organized health care education training program in O Fallon, IL. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Roy Marshall Wagner NPI is 1477187383. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
3 SAINT ELIZABETH BLVD STE 4000
O FALLON, IL
ZIP 62269
Phone: (618) 233-7880
Fax: (618) 222-4792
The NPI 1477187383 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 2/29/2020 and was last updated on 3/18/2020.