Individual
JESSICA WACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
809 E EMERALD AVE, KNOXVILLE, TN 37917-5550
(865) 524-7366
Mailing address
135 SHEFFIELD DR, CLINTON, TN 37716-6253
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5147
TN
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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