Deadra L Wagner, D.C.

NPI #1538290234 in Benton Harbor, Michigan

Provider Information

NPI Number: 1538290234
Entity Type: Individual
Name: Deadra L Wagner, D.C.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Chiropractor
Credential: D.C.
Enumeration Date: Mar 7, 2007
Last Updated: Jan 20, 2010

Practice Location

Address: 1459 MIAMI RD
City: Benton Harbor
State: Michigan
ZIP Code: 49022-6055
Phone: (269) 208-7031

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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