Vanwagner INC

NPI #1376191635 in Glen Allen, Virginia

Provider Information

NPI Number: 1376191635
Entity Type: Organization
Organization Name: Vanwagner INC
Primary Specialty: Chiropractor
Enumeration Date: Aug 29, 2019
Last Updated: Aug 29, 2019

Practice Location

Address: 10857 W BROAD ST
City: Glen Allen
State: Virginia
ZIP Code: 23060-3312
Phone: (804) 270-3000

Authorized Official

Name: SCOTT VANWAGNER, DC
Title: AUTHORIZED OFFICIAL
Phone: (804) 564-6110

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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