Individual
SCOTT WAGGONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1500 TRAILHEAD CT, GREENVILLE, SC 29617-6226
(864) 371-3100
Mailing address
204 VIEW FOREST CT, GREER, SC 29651-5384
(860) 550-5872
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4842
SC
Other
Enumeration date
03/16/2022
Last updated
03/16/2022
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