Wagner, Shane L

Wagner, Shane L is an individual health care provider with primary practice located at 3111 S 70Th St , Fort Smith AR 72903-5017. He recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as his primary health care specialty. Wagner, Shane L can be contacted via phone (479) 452-6650.

Contact Information

Primary practice address
3111 S 70Th St Fort Smith AR 72903-5017
Phone: (479) 452-6650
Fax: (479) 452-5847
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1548413925
LBN Legal business name Wagner, Shane L
Credentials MHPP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 29th, 2008
Last updated Mar 6th, 2024 - about 2 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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