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Individual

RYAN CHRIS MOELLENKAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
90 VERMONT AVE STE 300, OAK RIDGE, TN 37830-6478
(865) 481-2541
(865) 483-8151
Mailing address
90 VERMONT AVE STE 300, OAK RIDGE, TN 37830-6478
(865) 481-2541
(865) 483-8151

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-05615
NC
363A00000X
Physician Assistant
Primary
2928
TN
363AS0400X
Surgical Physician Assistant
2928
TN

Other

Enumeration date
03/11/2015
Last updated
07/03/2019
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