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NPI Code Detail

MEDICARE: WAGNER FAMILY CHIROPRACTIC SC

MEDICARE: WAGNER FAMILY CHIROPRACTIC SC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor4062-012WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295857928
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAGNER FAMILY CHIROPRACTIC SC
Provider Business Mailing Address
First Line : N110 BRUX RD
Second Line :
City : APPLETON
State : WI
Zip : 54915-9439
Country : US
Telephone Number : 920-968-0464
Fax Number : 920-968-0482
Provider Business Practice Location Address
First Line : N110 BRUX RD
Second Line :
City : APPLETON
State : WI
Zip : 54915-9439
Country : US
Telephone Number : 920-968-0464
Fax Number : 920-968-0482
Authorized Official
Title or Position : SECRETARY
Name : MICHAEL WAGNER
Credential : D.C.
Telephone Number : 920-968-0464
Provider Enumeration Date : 04/04/2007
Last Update Date : 06/11/2024

Similar Medicare Providers

1740283183 — DR. MICHAEL RYAN WAGNER D.C.
Practice Location Address:
N110 BRUX RD
APPLETON, WI
54915-9439
Practice Phone: 920-968-0464
Practice Fax: 920-968-0482
1487656799 — DR. JODY MICHELLE WAGNER D.C.
Practice Location Address:
N110 BRUX RD
APPLETON, WI
54915-9439
Practice Phone: 920-968-0464
Practice Fax: 920-968-0482
1356333447 — DR. MEGAN ELIZABETH GORDLEY DC
Practice Location Address:
N110 BRUX RD
APPLETON, WI
54915-9439
Practice Phone: 920-968-0464
Practice Fax: 920-968-0482
1134588288 — WAGNER FAMILY CHIROPRACTIC SC
Practice Location Address:
N110 BRUX RD
APPLETON, WI
54915-9439
Practice Phone: 920-968-0464
Practice Fax: 920-968-0482
1548856370 — TAMI KLAUER
Practice Location Address:
N110 BRUX RD
APPLETON, WI
54915-9439
Practice Phone: 192-096-8046
Practice Fax:
1518612837 — MICHAEL RYAN FETTER DC
Practice Location Address:
N110 BRUX RD
APPLETON, WI
54915-9439
Practice Phone: 920-968-0464
Practice Fax: 920-968-0482

Directions to “WAGNER FAMILY CHIROPRACTIC SC ” Practice Location

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