Individual
MR. RICHARD K WAGGONER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
2116 W FAIDLEY AVE, STE 400, GRAND ISLAND, NE 68803-4671
(308) 381-0162
(308) 389-4445
Mailing address
2116 W FAIDLEY AVE, STE 400, GRAND ISLAND, NE 68803-4671
(308) 381-0162
(308) 389-4445
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
342000
NE
Other
Enumeration date
05/20/2006
Last updated
03/07/2023
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