Individual
DR. KATHRYN ANN WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
15945 CLAYTON RD STE 230C, BALLWIN, MO 63011-2491
(636) 256-5200
Mailing address
838 BROOKMEAD DR, O FALLON, MO 63366-7572
(314) 606-8044
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2017013442
MO
Other
Enumeration date
05/10/2017
Last updated
02/07/2022
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