Individual
DR. BURTON WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
647 CAMINO DE LOS MARES STE 220, SAN CLEMENTE, CA 92673-2807
(949) 616-5470
Mailing address
647 CAMINO DE LOS MARES, SUITE 220, SAN CLEMENTE, CA 92673-2825
(949) 616-5470
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27883
CA
Other
Enumeration date
04/15/2014
Last updated
04/20/2015
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