Individual
DR. ELLEN WANDA WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
5006 N BROADWAY ST, KNOXVILLE, TN 37918-2340
(865) 688-1812
Mailing address
5006 N BROADWAY ST, KNOXVILLE, TN 37918-2340
(865) 688-1812
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12235
TN
Other
Enumeration date
07/07/2010
Last updated
07/07/2010
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