Individual
DR. ANDREW MARK WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4357 13TH AVE S, SUITE 100, FARGO, ND 58103-3381
(701) 269-3219
Mailing address
3570 42ND ST S, APARTMENT 106, FARGO, ND 58104-6959
(701) 269-3219
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
809
ND
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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