| Doctor Name: | STEFFANIE WAGNER |
| NPI Number: | 1083957492 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DVM |
| License Number: | 7655356-2801 |
| Business Practice Address: | 308 W 7200 S Midvale, UT - 840471041 |
| Business Phone Number: | 8018710600 |
| Business Fax Number: | 8015661155 |
| Mailing Address: | 308 W 7200 S, MIDVALE |
| State: | UT |
| Postal Code: | 840471041 |
| Phone Number: | 8018710600 |
| Fax Number: | 8015661155 |
| NPI Enumeration Date: | 04/03/2013 |
| NPI Last Update Date: | 04/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174M00000X |
| License Number: | 7655356-2801 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Veterinarian |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |