Individual
JULIA MARIE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
3778 UNION ST, LAFAYETTE, IN 47905-4453
(765) 448-1674
Mailing address
3778 UNION ST, LAFAYETTE, IN 47905-4453
(765) 448-1674
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002812A
IN
Other
Enumeration date
12/02/2014
Last updated
12/02/2014
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