Individual
ANTASTASIA WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1222 10TH ST, WOODWARD, OK 73801-3156
(580) 256-9700
Mailing address
1222 10TH ST, WOODWARD, OK 73801-3156
(580) 256-9700
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
12/20/2024
Last updated
12/20/2024
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