LAURA WAGNER

KINGSPORT, TN
NPI1013628262
Former NameLAURA BAKER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant Medical
(Licence: TN  PA5304)
Enumeration Date2022-12-08
Last Update Date2024-06-21
Business Address
LAURA WAGNER
105 W STONE DR STE 1F
KINGSPORT, TN 37660-3365
Phone number: 423-230-2420
Mailing Address
LAURA WAGNER
PO BOX 9
KINGSPORT, TN 37662-0009
Phone number: 423-857-2066
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