Individual
DR. TIMOTHY JOHN WAGNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C., B.S.
Contact information
Practice address
118 N DURKEE ST, APPLETON, WI 54911-5427
(920) 830-2225
(920) 830-2221
Mailing address
118 N DURKEE ST, APPLETON, WI 54911-5427
(920) 830-2225
(920) 830-2221
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4002-012
WI
Other
Enumeration date
09/26/2005
Last updated
07/08/2007
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