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Individual

KENDRA L GAGNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
600 EAST ST, LATHROP, MO 64465-9786
(816) 721-9459
(913) 588-4568
Mailing address
600 EAST ST, LATHROP, MO 64465-9786
(816) 721-9459
(913) 588-4568

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2003001208
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
48845140
MO
Enumeration date
08/19/2008
Last updated
08/19/2008
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