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DEADRA L WAGNER D.C.
NPI 1538290234
Chiropractor in Benton Harbor, MI

Active since March 07, 2007
1459 MIAMI RD, BENTON HARBOR, MI 49022(269) 208-7031 Get Directions Write a Review

NPPES record last updated: January 20, 2010. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Deadra L Wagner D.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEADRA L WAGNER D.C. (NPI 1538290234) is an individual chiropractor in Benton Harbor, Michigan, licensed in Illinois (038009468) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1538290234
Entity TypeIndividualFemale
Primary Taxonomy111N00000X
Provider Legal NameDEADRA L WAGNERCredential: D.C.
Location Address1459 MIAMI RDBenton Harbor, MI 49022-6055
Mailing Address1459 Miami RdBenton Harbor, MI 49022-6055 · (269) 208-7031
Phone(269) 208-7031
Sole ProprietorYes
Enumeration DateMarch 7, 2007
Last NPPES UpdateJanuary 20, 2010
✔ NPI 1538290234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in IL · 038009468
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
1459 MIAMI RD, Benton Harbor, MI 49022
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Other Identifiers 2

Medicare UPINU96645IL
Medicare ID-Type UnspecifiedK00833IL

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deadra Wagner's NPI number?

The NPI number for Deadra Wagner is 1538290234. It was assigned to this individual provider in the NPPES registry on March 7, 2007.

Where is Deadra Wagner located?

Deadra Wagner practices at 1459 Miami Rd, Benton Harbor, MI 49022. The listed phone number is (269) 208-7031.

What is Deadra Wagner's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Deadra Wagner was last updated on January 20, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.