Individual
ANDREW WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2601 NE KENDALLWOOD PKWY STE 101, GLADSTONE, MO 64119-2171
(816) 868-3680
Mailing address
19803 NE 102ND ST, LIBERTY, MO 64068-8735
(816) 868-3680
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2022001832
MO
Other
Enumeration date
02/08/2022
Last updated
02/08/2022
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