Individual
KAYLA RILEY WAGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1016 FLETCHER ST, WILKESBORO, NC 28697-9472
(336) 667-9261
Mailing address
1016 FLETCHER ST, WILKESBORO, NC 28697-9472
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
NC
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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