Individual
MR. RONNIE A WAGLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.P.T.
Contact information
Practice address
1005 FISHER RD, MANY, LA 71449-3833
(318) 256-0800
(318) 238-2811
Mailing address
101 ISADORE ST, NATCHITOCHES, LA 71457-5747
(318) 238-2820
(318) 238-2811
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04564
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04564
LOUISIANA STATE BOARD OF PHYSICAL THERAPY EXAMINERS
LA
Enumeration date
10/21/2008
Last updated
02/08/2010
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