Individual
JAMIE WAGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
6651 E CARONDELET DR, TUCSON, AZ 85710-2118
(520) 731-8533
(520) 731-8530
Mailing address
1842 S SUNBURST PL, TUCSON, AZ 85748-7523
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5482
AZ
Other
Enumeration date
07/26/2008
Last updated
07/26/2008
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