Individual
PENNY WAGGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
104 SW GRAY CIR, LEES SUMMIT, MO 64081-4135
(816) 765-5211
Mailing address
104 SW GRAY CIR, LEES SUMMIT, MO 64081-4135
(816) 765-5211
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01798
MO
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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