MRS. Jennifer Lee Wagoner, P.T.

NPI #1861785206 in Macomb, Illinois

Provider Information

NPI Number: 1861785206
Entity Type: Individual
Name: MRS. Jennifer Lee Wagoner, P.T.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: P.T.
Enumeration Date: May 18, 2011
Last Updated: Feb 10, 2022

Practice Location

Address: 505 E GRANT ST
City: Macomb
State: Illinois
ZIP Code: 61455-3352
Phone: (309) 833-1733

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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