Wayne L. Wagoner, Dpm, Pc

NPI 1568707446 - Clinic/Center - 261QP1100X

NPI Details
NPI 1568707446
Enumeration Date 12/04/2012
Last Updated 12/04/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name WAYNE LEROY WAYNE
Position OWNER
Phone (563) 652-9777
Fax (563) 652-9778
Practice Location
515 ROSEMERE LN
MAQUOKETA IA, 52060-2615, US
Phone (563) 652-9777
Fax (563) 652-9778
Business Location
515 ROSEMERE LN
MAQUOKETA IA, 52060-2615, US
Phone (563) 652-9777
Fax (563) 652-9778
Toxanomy
Taxonomy Code 261QP1100X
License State Iowa
License Number 00526
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According to our database, Wayne L. Wagoner, Dpm, Pc NPI is 1568707446, taxonomy code is 261QP1100X and license number is 00526, license state is located at Iowa. Wayne L. Wagoner, Dpm, Pc physically located at 515 Rosemere Ln, Maquoketa IA, 52060-2615. NPI Number 1033115704 has the healthcare provider type.

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1568707446 NPI number is provided on an as is basis without warranty of any kind. 1568707446 is maintained by the National Plan & Provider Enumeration System. The contents of Wayne L. Wagoner, Dpm, Pc are for informational purposes only.