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Organization
WAGGENER CHIROPRACTIC AND WELLNESS CENTER LLC
Active
Organization
WAGGENER CHIROPRACTIC AND WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA ARIEL MAYBERRY DC (OWNER/CHIROPRACTOR)
(217) 679-3637
Entity
Organization
Contact information
Practice address
7012 KINGSMILL CT, SPRINGFIELD, IL 62711
(217) 679-3637
Mailing address
7012 KINGSMILL CT, SPRINGFIELD, IL 62711-7387
(121) 767-9363
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038012923
IL
Other
Enumeration date
04/19/2018
Last updated
05/17/2018
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