Wagner, Clifford Gerard

Wagner, Clifford Gerard is an individual health care provider with primary practice located at 53 Woodruff Street , Saranac Lake NY 12983. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Wagner, Clifford Gerard can be contacted via phone (518) 891-1326.

Contact Information

Primary practice address
53 Woodruff Street Saranac Lake NY 12983
Fax: (518) 891-1326
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X X0069381 New York

Profile Details

NPI number 1467536797
LBN Legal business name Wagner, Clifford Gerard
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467536797 NPPES
New York Other CO69387 WORKERS COMPENSATION

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