Organization
JAY J FITZGERALD DC
Active
Other names
Wagner Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY JOSEPH FITZGERALD D.C. (OWNER)
(605) 384-5419
Entity
Organization
Contact information
Practice address
109 1ST ST. SW, WAGNER, SD 57380-0758
(605) 384-5419
(605) 384-5410
Mailing address
109 1ST ST. SW, P.O. BOX 758, WAGNER, SD 57380-0758
(605) 384-5419
(605) 384-5410
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
840
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7604080
—
SD
Enumeration date
03/19/2007
Last updated
04/16/2008
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