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General NPI Number Information
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NPI Number | 1194279406
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Entity Type | Individual
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Provider Name | KERRI ANN WAEGELEIN DPT, OCS
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Gender | Female
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 163 RUTLEDGE AVE
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City | CHARLESTON
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State | SC
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Zip | 29403-5816
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Country | US
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Telephone | 843-480-0908
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 WOODSIDE DR
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City | CHARLESTON
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State | SC
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Zip | 29412-9360
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Country | US
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Telephone | 845-242-8732
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 8158
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License Number State | SC
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