DR. Wallace J Wagner

NPI #1275507089 in Sioux City, Iowa

Provider Information

NPI Number: 1275507089
Entity Type: Individual
Name: DR. Wallace J Wagner
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Chiropractor
Enumeration Date: Feb 16, 2006
Last Updated: Dec 18, 2013

Practice Location

Address: 1723 GRANDVIEW BLVD
City: Sioux City
State: Iowa
ZIP Code: 51105-1116
Phone: (712) 258-1021

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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