Most Relevant Information
Provider Data
| NPI Number: | 1003566985 |
| Provider Name: | CHELSAE WAGNER |
| Entity Type: | Individual |
| Taxonomy Code: | 3104A0625X |
| Specialty: | Assisted Living Facility |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/24/2022 |
| Last Updated: | 03/24/2022 |
Provider Practice Location
8005 COUNTY ROAD E45
WYOMING
IA
523627514
Practice Location Phone/Fax
| Phone: | 3199298702 |
| Fax: |
Provider Mailing Location
8005 COUNTY ROAD E45
WYOMING
IA
523627514
Provider Mailing Phone/Fax
| Phone: | 3199298702 |
| Fax: |