Individual
JACKIE VOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
209 LAKESHORE DR, RUSHVILLE, MO 64484-9531
(816) 261-2414
Mailing address
209 LAKESHORE DR, RUSHVILLE, MO 64484-9531
(816) 261-2414
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-02607
KS
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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