Individual
BLAKE JOSEPH WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
21505 MARKET PL NW, SUITE 102, POULSBO, WA 98370-6635
(360) 598-3143
(360) 598-4172
Mailing address
21505 MARKET PLACE NW, SUITE 102, POULSBO, WA 98370
(360) 598-3143
(360) 598-4172
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00003095
WA
Other
Enumeration date
02/03/2007
Last updated
04/25/2011
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