Most Relevant Information
Provider Data
| NPI Number: | 1003033846 |
| Provider Name: | TESSA WAGGONER PT |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 24735 |
Most Important Dates
| Enumeration Date: | 04/20/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1701 SOLAR DR
STE. 155
OXNARD
CA
930300134
Practice Location Phone/Fax
| Phone: | 8056044644 |
| Fax: | 8056044434 |
Provider Mailing Location
1701 SOLAR DR.
STE. 155
OXNARD
CA
930300134
Provider Mailing Phone/Fax
| Phone: | 8056044644 |
| Fax: | 8056044434 |