Individual
MRS. KATHERINE ANNE WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6360 W. CENTER AVE, LAKEWOOD, CO 80226
(303) 347-8848
(303) 997-6123
Mailing address
6360 W CENTER AVE, LAKEWOOD, CO 80226-3401
(303) 347-8848
(303) 997-6123
Taxonomy
Speciality
Code
Description
License number
State
211D00000X
Podiatric Assistant
Primary
12867
CO
Other
Enumeration date
12/19/2008
Last updated
12/19/2008
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