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Individual
PATRICK JOHN WAGENER
Active
Individual
PATRICK JOHN WAGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5620-12
WI
Other
Enumeration date
02/17/2021
Last updated
02/17/2021
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