Individual
CLIFFORD GERARD WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
53 WOODRUFF STREET, SARANAC LAKE, NY 12983
(518) 891-1326
(518) 891-1326
Mailing address
53 WOODRUFF STREET, SARANAC LAKE, NY 12983
(518) 891-1326
(518) 891-1326
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X0069381
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO69387
WORKERS COMPENSATION
NY
Enumeration date
10/24/2006
Last updated
07/08/2007
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