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Organization
SAN CLEMENTE VITALITY CENTER INC.
Active
Organization
SAN CLEMENTE VITALITY CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BURTON WAGNER D.C. (OWNER/PROVIDER)
(949) 441-7755
Entity
Organization
Contact information
Practice address
647 CAMINO DE LOS MARES, STE 218, SAN CLEMENTE, CA 92673-2807
(949) 441-7755
(949) 598-9990
Mailing address
15520 ROCKFIELD BLVD, #A200, IRVINE, CA 92618-6705
(949) 598-9999
(949) 598-9990
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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