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Organization
WAGONER CHIROPRACTIC INC
Active
Organization
WAGONER CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAYLA ELLEN WAGONER D.C. (OWNER/SECRETARY)
(814) 954-4182
Entity
Organization
Contact information
Practice address
454 ROLLING RIDGE DR, SUITE 4, STATE COLLEGE, PA 16801-7696
(814) 954-4182
Mailing address
454 ROLLING RIDGE DR, SUITE 4, STATE COLLEGE, PA 16801-7696
(814) 954-4182
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
05/29/2015
Last updated
06/24/2015
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