Individual
KEITH E RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
202 SAM WALTON DR, SPARTA, TN 38583-8810
(931) 738-3340
(931) 738-8558
Mailing address
202 SAM WALTON DR, SPARTA, TN 38583-8810
(931) 738-3340
(931) 738-8558
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6308
TN
Other
Enumeration date
04/23/2018
Last updated
04/23/2018
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