Jason Waggoner, RPH

NPI #1033713524 in Mattoon, Illinois

Provider Information

NPI Number: 1033713524
Entity Type: Individual
Name: Jason Waggoner, RPH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Nov 24, 2020
Last Updated: Nov 24, 2020

Practice Location

Address: 1316 CHARLESTON AVE
City: Mattoon
State: Illinois
ZIP Code: 61938-4016
Phone: (217) 258-2920

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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