Individual
KYLE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15610 SE 272ND ST BLDG A, COVINGTON, WA 98042-4416
(253) 638-2424
Mailing address
15610 SE 272ND ST BLDG A, COVINGTON, WA 98042-4416
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH60849715
WA
Other
Enumeration date
06/04/2018
Last updated
03/25/2024
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