Individual
MS. JANE EILEEN WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
600 MEDICAL CENTER DR, NEWTON, KS 67114-8780
(316) 804-6202
(316) 804-6270
Mailing address
600 MEDICAL CENTER DR, PO BOX 308, NEWTON, KS 67114-8780
(316) 804-6202
(316) 804-6270
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-00326
KS
Other
Enumeration date
09/21/2007
Last updated
09/21/2007
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