Individual
DR. BARRY D WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1431 INTERSTATE LOOP, BISMARCK, ND 58503-0510
(701) 223-5001
(701) 223-4709
Mailing address
1431 INTERSTATE LOOP, BISMARCK, ND 58503-0510
(701) 223-5001
(701) 223-4709
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
061
ND
111N00000X
Chiropractor
3494
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17241
—
ND
01
—
19785
BCBS OF ND
ND
Enumeration date
10/27/2006
Last updated
08/13/2013
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