Mrs Tracy Lee Waggoner, MPT | |
609 N Pleasant St, Hutsonville, IL 62433-1119 | |
(618) 563-9395 | |
Not Available |
Full Name | Mrs Tracy Lee Waggoner |
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Gender | Female |
Speciality | Physical Therapist |
Location | 609 N Pleasant St, Hutsonville, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487856548 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (Illinois) | Primary |
Provider Name | Athletic And Therapeutic Institute Of Naperville, Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1023129681 PECOS PAC ID: 8325014020 Enrollment ID: O20040903000494 |
Provider Name | Athletic And Therapeutic Institute Of Bourbonnais, Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1861503542 PECOS PAC ID: 4183692577 Enrollment ID: O20040923000220 |
Provider Name | Empowerme Rehabilitation Illinois Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1679098263 PECOS PAC ID: 2365718277 Enrollment ID: O20171020001353 |
Provider Name | Empowerme Wellness Kansas City Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1174118103 PECOS PAC ID: 9830504836 Enrollment ID: O20210317001954 |
Mailing Address | Practice Location Address |
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Mrs Tracy Lee Waggoner, MPT 1000 N Allen St, Robinson, IL 62454-1167 Ph: (618) 546-2695 | Mrs Tracy Lee Waggoner, MPT 609 N Pleasant St, Hutsonville, IL 62433-1119 Ph: (618) 563-9395 |