Individual
MR. JEFFREY M WAGGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPED
Contact information
Practice address
12120 LIV 302, CHILLICOTHE, MO 64601-8210
(660) 646-1517
Mailing address
12120 LIV 302, CHILLICOTHE, MO 64601-8210
(660) 646-1517
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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