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NPI 1801753322

NPI 1801753322 : VANWAGNER INC : GLEN ALLEN, VA

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General NPI Number Information
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    NPI Number           |    1801753322
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    Entity Type          |    Organization 
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    Legal Business Name  |    VANWAGNER INC 
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Dates
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    Enumeration Date     |    01/07/2026
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    Last Update Date     |    01/07/2026
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Provider Practice Location Address
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    Address Line         |    10857 W BROAD ST 
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    City                 |    GLEN ALLEN
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    State                |    VA
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    Zip                  |    23060-3312
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    Country              |    US
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    Telephone            |    804-270-3000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10857 W BROAD ST 
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    City                 |    GLEN ALLEN
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    State                |    VA
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    Zip                  |    23060-3312
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    Country              |    US
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    Telephone            |    804-270-3000
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    Fax                  |    804-270-3004
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. SCOTT A VANWAGNER 
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    Credential           |    DC
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    Telephone            |    804-270-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    
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    License Number State |    
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