Individual
DR. EVAN JONATHON WAGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1408 WOODLAND HILLS TRL, APT 204, WAKE FOREST, NC 27587-1778
(260) 573-1249
Mailing address
1408 WOODLAND HILLS TRL, APT 204, WAKE FOREST, NC 27587-1778
(260) 573-1249
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5176
NC
Other
Enumeration date
04/22/2020
Last updated
10/26/2021
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