Individual
ELTON BERT JOHNSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8046 MACON RD, CORDOVA, TN 38018-8531
(901) 753-1331
Mailing address
951 BEGALL CV, CORDOVA, TN 38018-6322
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8351
TN
183500000X
Pharmacist
E-06584
MS
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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