Individual
RENEE COLLETTE WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD LD
Contact information
Practice address
1530 LONE OAK RD, PADUCAH, KY 42003-7901
(270) 444-2909
(270) 444-2977
Mailing address
1530 LONE OAK RD, PO BOX 7100, PADUCAH, KY 42003-7901
(270) 444-2909
(270) 444-2977
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
KY-0158
KY
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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