San Clemente Vitality Center Inc.

NPI #1134773971 in San Clemente, California

Provider Information

NPI Number: 1134773971
Entity Type: Organization
Organization Name: San Clemente Vitality Center Inc.
Primary Specialty: Chiropractor
Enumeration Date: Jul 30, 2019
Last Updated: Jul 30, 2019

Practice Location

Address: 647 CAMINO DE LOS MARES
Address 2: STE 218
City: San Clemente
State: California
ZIP Code: 92673-2807
Phone: (949) 441-7755

Authorized Official

Name: BURTON WAGNER, D.C.
Title: OWNER/PROVIDER
Phone: (949) 441-7755

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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