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Individual
DR. LEE ANNE MATHENA TADLOCK
Active
Individual
DR. LEE ANNE MATHENA TADLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19781
NC
183500000X
Pharmacist
31770
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033530985
NPI
OH
01
—
46-1317638
TAX ID
—
Enumeration date
11/03/2010
Last updated
03/23/2017
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