Individual
DR. SAMUEL WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2525 W MASON ST, GREEN BAY, WI 54303-4838
(920) 429-2844
Mailing address
2525 W MASON ST, GREEN BAY, WI 54303-4838
(920) 429-2844
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5680-12
WI
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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