BLAIR ELLEN WAGONER

LEXINGTON, KY
NPI1891939344
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2251P0200X Physical Therapist, Pediatrics
(Licence: KY  PT005412)
Additional Taxonomies225100000X Physical Therapist
(Licence: AR  PT 3141)
Enumeration Date2009-04-28
Last Update Date2010-04-09
Business Address
-- BLAIR ELLEN WAGONER
1001 MONARCH ST SUITE 110
LEXINGTON, KY 40513-1495
Phone number: 859-224-0834
Mailing Address
-- BLAIR ELLEN WAGONER
115 WEST DR
MURRAY, KY 42071-9830
Phone number: 270-293-0758