Individual
MARK JACOB MESIBOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4560 HARDING PIKE, NASHVILLE, TN 37205-6101
(615) 297-2279
Mailing address
4560 HARDING PIKE, NASHVILLE, TN 37205-6101
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
46464
TN
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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