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Individual

JENNIFER RENEE WAGGONER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
427 W ORCHARD ST STE D, VANDALIA, IL 62471-1256
(618) 322-4491
Mailing address
6700 WASHINGTON AVE S, EDEN PRAIRIE, MN 55344-3405
(460) 295-2947
(163) 750-7512

Taxonomy

Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
237700000X
Hearing Instrument Specialist
Primary
3360
IL

Other

Enumeration date
06/14/2019
Last updated
06/20/2019
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