| NPI | 1164796181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MICHAEL WAGNER Owner 410-267-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: MD S01457) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-03-08 |