Individual
KATHERINE A WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7591 TYLERS PLACE BLVD, WEST CHESTER, OH 45069-6308
(513) 755-6600
Mailing address
7591 TYLERS PLACE BLVD, WEST CHESTER, OH 45069-6308
(513) 755-6600
(513) 755-3762
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
007502
KY
225100000X
Physical Therapist
Primary
PT017594
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2187155
—
OH
01
—
AB7360731
MEDICARE PIN
OH
Enumeration date
10/31/2018
Last updated
10/31/2018
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