Organization
WAGGONER CHIROPRACTIC HEALTH CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLINTON C WAGGONER D.C. (CHIROPRACTOR)
(719) 634-2579
Entity
Organization
Contact information
Practice address
824 E FILLMORE ST, COLORADO SPRINGS, CO 80907-6375
(719) 634-2579
(719) 634-2371
Mailing address
824 E FILLMORE ST, COLORADO SPRINGS, CO 80907-6375
(719) 634-2579
(719) 634-2371
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
2257
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C27393
PTAN
CO
Enumeration date
05/13/2014
Last updated
05/13/2014
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