Individual
SCOTT J WAGENKNECHT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
8405 W FOREST HOME AVE, STE 101, GREENFIELD, WI 53228-3407
(414) 423-9225
(414) 421-7516
Mailing address
8405 W FOREST HOME AVE, STE 101, GREENFIELD, WI 53228-3407
(414) 423-9225
(414) 421-7516
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3592 012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38925100
—
WI
Enumeration date
08/16/2005
Last updated
07/08/2007
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