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General NPI Number Information
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NPI Number | 1518349943
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Entity Type | Individual
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Provider Name | CARRIE WADMAN MA, CRC, ADS
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Gender | Female
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 1501 BOYD ST
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City | KNOXVILLE
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State | TN
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Zip | 37921-4802
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Country | US
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Telephone | 813-541-0145
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Fax |
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Provider Business Mailing Address
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Address Line | 1825 KNOB RD
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City | MARYVILLE
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State | TN
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Zip | 37803-9450
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Country | US
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Telephone | 813-541-0145
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | ACU0000000279
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License Number State | TN
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