Individual
MYLA WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1222 MARKET ST, PARKERSBURG, WV 26101-4323
(304) 865-5420
(304) 465-0886
Mailing address
317 DUTCH RIDGE RD, PARKERSBURG, WV 26104-7133
(681) 315-0022
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
09/23/2022
Last updated
09/23/2022
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