| Wagner Performance Chiropractic | |
|
1001 Se 3rd Ave Amarillo TX 79102-3201 | |
| (806) 318-0632 | |
| Not Available |
| Full Name | Wagner Performance Chiropractic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1001 Se 3rd Ave, Amarillo, Texas |
| Authorized Official Name and Position | Grant Curtis Wagner (DOCTOR/OWNER) |
| Authorized Official Contact | 5756077097 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wagner Performance Chiropractic 6404 Nancy Ellen St Amarillo TX 79119-6325 Ph: (575) 607-7097 | Wagner Performance Chiropractic 1001 Se 3rd Ave Amarillo TX 79102-3201 Ph: (806) 318-0632 |
| NPI Number | 1689355836 |
|---|---|
| Provider Enumeration Date | 07/31/2023 |
| Last Update Date | 07/31/2023 |
| Medicare PECOS PAC ID | 0345695326 |
|---|---|
| Medicare Enrollment ID | O20231011001345 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689355836 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Grant Wagner |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1881378743 PECOS PAC ID: 4789039769 Enrollment ID: I20231011001775 |
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