Individual
MR. JONATHAN DOUGLAS WAYNE REAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
200 W COMMERCIAL ST, LEBANON, MO 65536-3146
(417) 718-0712
Mailing address
PO BOX 1736, LEBANON, MO 65536
(417) 718-0712
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2001015007
MO
Other
Enumeration date
10/10/2006
Last updated
07/03/2025
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