Individual
HEATHER GAGNON WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS PT
Contact information
Practice address
8340 LINDEN LANE, PRAIRIE VILLAGE, KS 66207
(913) 707-4303
Mailing address
8340 LINDEN LANE, PRAIRIE VILLAGE, KS 66207
(913) 707-4303
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11-02753
KS
225100000X
Physical Therapist
Primary
119884
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
484700406
—
MO
Enumeration date
02/13/2006
Last updated
01/15/2015
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