Individual
TAMMY LOUISE WALDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10450 NE REINKING RD, KANSAS CITY, MO 64156-1122
(816) 699-7241
Mailing address
10450 NE REINKING RD, KANSAS CITY, MO 64156-1122
(816) 699-7241
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9539
VA
—
Enumeration date
03/02/2020
Last updated
03/02/2020
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