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Individual

JAELYN KELLY HAGGARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
24007 BUSINESS HIGHWAY 71, MARYVILLE, MO 64468-8235
(660) 224-0107
(660) 224-0108
Mailing address
2604 SHADOW CT, SAINT JOSEPH, MO 64503-1900
(816) 752-5288

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2023032664
MO

Other

Enumeration date
08/17/2023
Last updated
08/17/2023
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