Individual
DR. JACK JEFFREY WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1425 E CENTER ST, KINGSPORT, TN 37664-2501
(423) 245-2181
Mailing address
1233 EASTBROOK DR, KINGSPORT, TN 37663-2407
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
34420
TN
Other
Enumeration date
01/09/2011
Last updated
01/09/2011
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