Individual
DR. GARY L WAGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1337 S GILBERT RD STE 105, MESA, AZ 85204
(480) 343-0585
(480) 635-1719
Mailing address
PO BOX 9616, CHANDLER HEIGHTS, AZ 85227
(480) 343-0585
(480) 635-1719
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
DC28876
CA
111NX0100X
Occupational Health Chiropractor
Primary
8098
AZ
Other
Enumeration date
10/23/2006
Last updated
05/23/2018
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