| NPI | 1750521209 |
|---|---|
| Former Legal Business Name | WAGNER CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | JAMISON MATTHEW WAGNER President 712-258-1021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: IA 06696) |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2009-02-24 |