Individual provider · Type 1 NPI

Jonathan Waggonner, PTA, CMT

Massage Therapist · Redlands, CA

NPI number 1962201558 Active

Practice location

1455 W Park Ave
Redlands, CA 92373-8178

Call (909) 793-2225 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XNone listed

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1962201558

Jonathan Waggonner, PTA, CMT's National Provider Identifier is 1962201558, issued on Mar 7, 2025. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Redlands, CA. The record was last updated on Mar 7, 2025.