Individual
MISS MEGAN WAGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7311 NW DONOVAN DR, APT 247, KANSAS CITY, MO 64153-2403
(816) 804-0558
Mailing address
7311 NW DONOVAN DR, APT 247, KANSAS CITY, MO 64153
(816) 804-0558
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2012030158
MO
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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