Individual
ADAM WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 1ST ST N STE 105, SAINT CLOUD, MN 56303-1924
(320) 774-1355
Mailing address
3400 1ST ST N STE 105, SAINT CLOUD, MN 56303-1924
(320) 774-1355
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6987
MN
2255A2300X
Athletic Trainer
T530255488808
MN
Other
Enumeration date
01/02/2015
Last updated
07/22/2022
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