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Individual

MICHELLE WAGGONER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3870 W ANN RD, NORTH LAS VEGAS, NV 89031-4411
(702) 396-7100
Mailing address
9222 FOREST MEADOWS AVE, LAS VEGAS, NV 89149-0707

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-1409
NV

Other

Enumeration date
08/02/2021
Last updated
08/02/2021
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