Jeremy M Wagnon D.C.

NPI 1679879050 - Chiropractor - 111N00000X

NPI Details
NPI 1679879050
Gender Male
Enumeration Date 02/02/2011
Last Updated 07/06/2012
Entity Type Individual
Active Over 5 years ago
Practice Location
615 PENNSYLVANIA AVE
SHEBOYGAN WI, 53081-4642, US
Phone (404) 754-6779
Fax
Business Location
615 PENNSYLVANIA AVE
SHEBOYGAN WI, 53081-4642, US
Phone (404) 754-6779
Fax
Toxanomy
Taxonomy Code 111N00000X
License State Georgia
License Number CHIR008777
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According to our database, Dr. Jeremy M Wagnon D.C. NPI is 1679879050, taxonomy code is 111N00000X and license number is CHIR008777, license state is located at Georgia. Jeremy M Wagnon D.C. physically located at 615 Pennsylvania Ave, Sheboygan WI, 53081-4642. NPI Number Jeremy M Wagnon D.C. has the Individual type.

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1679879050 NPI number is provided on an as is basis without warranty of any kind. 1679879050 is maintained by the National Plan & Provider Enumeration System. The contents of Jeremy M Wagnon D.C. are for informational purposes only.