Individual
DR. KIMBERLY GOULD LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM. D.
Contact information
Practice address
525 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-8213
(423) 926-3338
Mailing address
1861 GREENBRIAR CIRCLE, ELIZABETHTON, TN 37643
(423) 543-9167
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10824
TN
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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