Individual
MOLLY ANN WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9050 EXECUTIVE PARK DR STE 100B, KNOXVILLE, TN 37923-4616
(865) 217-1297
Mailing address
379 MIKE MILLER LN, CLINTON, TN 37716-6545
(865) 660-8236
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4115
TN
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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