# WAGEMAN CHIROPRACTIC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891038600
- **Authorized official:** DR. RANDALL NED WAGEMAN D.C. (PRESIDENT WAGEMAN CHIROPRACTIC PC)
- **Authorized official phone:** (435) 628-3500

## Contact information

- **Practice address:** 720 S RIVER RD, STE. E-103, ST GEORGE, UT 84790-5507
- **Practice address phone:** (435) 628-3500
- **Practice address fax:** (435) 628-0476
- **Mailing address:** 720 S RIVER RD, STE. E-103, ST GEORGE, UT 84790-5507
- **Mailing address phone:** (435) 628-3500
- **Mailing address fax:** (435) 628-0476

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NN1001X | Nutrition Chiropractor | 170227-1202 | UT | Yes |

## Other

- **Enumeration date:** 03/29/2013
- **Last updated:** 03/29/2013