Individual
MR. MICHAEL OWEN LEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
5380 HWY 153, K-MART PHARMACY 7118, HIXSON, TN 37343
(423) 870-8562
Mailing address
9704 STARRY WAY, SODDY DAISY, TN 37379-4069
(423) 558-0204
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0559
TN
Other
Enumeration date
09/29/2009
Last updated
09/29/2009
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