Individual
DR. BRANDON JAMES WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3778 UNION ST, LAFAYETTE, IN 47905-4453
(765) 448-1674
Mailing address
6504 AMHERST WAY, ZIONSVILLE, IN 46077-9138
(765) 412-2490
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08003257A
IN
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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