Wallace J Wagner Valid NPI
Individual provider · Chiropractor · Sioux City, IA
- NPI
- 1275507089
- Type
- Individual (Type 1)
- Primary specialty
- Chiropractor
- Specialty group
- Chiropractic Providers
- Taxonomy code
- 111N00000X
- License number
- 04516 (IA)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2006-02-16
- Last updated
- 2013-12-18
Practice location
1723 Grandview Blvd
Sioux City, IA 51105-1116
(712) 258-1021