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Individual

MR. LAURENS TRAVIS LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPH

Contact information

Practice address
2600 HILLSBORO PIKE APT 106, NASHVILLE, TN 37212-5635
(615) 948-9821
Mailing address
2600 HILLSBORO PIKE APT 106, NASHVILLE, TN 37212-5635
(615) 948-9821

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6523
TN

Other

Enumeration date
08/17/2007
Last updated
08/17/2007
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