Individual
PATRICK JOHN WAGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
409 E MILWAUKEE ST, JANESVILLE, WI 53545-3184
(608) 754-3192
Mailing address
409 E MILWAUKEE ST, JANESVILLE, WI 53545-3184
(608) 754-3192
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5620-12
WI
Other
Enumeration date
02/17/2021
Last updated
02/17/2021
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