Individual
JOHNATHAN MICHAEL DO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
580 HARTSVILLE PIKE, GALLATIN, TN 37066-2450
(615) 452-4253
Mailing address
218 HONEYSUCKLE LN, LEBANON, TN 37087-2481
(615) 668-6636
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
41433
TN
Other
Enumeration date
08/06/2017
Last updated
10/06/2020
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