Wagnon, Jeffrey Lynn

Wagnon, Jeffrey Lynn is an individual health care provider with primary practice located at 309 Regency Pkwy Ste 205 , Mansfield TX 76063-7305. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Wagnon, Jeffrey Lynn can be contacted via phone (817) 453-0430.

Contact Information

Primary practice address
309 Regency Pkwy Ste 205 Mansfield TX 76063-7305
Phone: (817) 453-0430
Fax: (817) 453-0400
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 9382 Texas

Profile Details

NPI number 1366591356
LBN Legal business name Wagnon, Jeffrey Lynn
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Jan 2nd, 2013 - about 11 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 1366591356 NPPES
Texas Other 8R1160 BLUE CROSS BLUE SHIELD #

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