Organization
BAPTIST HEALTH
Active
Parent organization
1942391230
Organization subpart
Yes
Provider details
NPI number
Legal business name
1942391230
Authorized official
MRS. NANCY E. WAGGONER M.S. CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(334) 358-6501
Entity
Organization
Contact information
Practice address
635 MCQUEEN SMITH RD N, SUITE D, PRATTVILLE, AL 36066-5660
(334) 358-6501
(334) 358-6521
Mailing address
635 MCQUEEN SMITH RD N, SUITE D, PRATTVILLE, AL 36066-5660
(334) 358-6501
(334) 358-6521
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
2907
AL
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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