Individual
DR. PHILIP JON WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1 PINCKNEY BLVD, NAVAL HOSPITAL BEAUFORT ATTN PROFESSIONAL AFFAIRS, BEAUFORT, SC 29902-6122
(843) 228-5577
(843) 228-5196
Mailing address
1 PINCKNEY BLVD, NAVAL HOSPITAL BEAUFORT ATTN PROFESSIONAL AFFAIRS, BEAUFORT, SC 29902-6122
(843) 228-5577
(843) 228-5196
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
1633
SC
Other
Enumeration date
12/20/2005
Last updated
07/08/2007
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