Individual
LORELEI B CORDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1224 HUNTSVILLE HWY, FAYETTEVILLE, TN 37334-3618
(931) 433-0011
Mailing address
11 N KING RD, FLINTVILLE, TN 37335-5321
(931) 993-9246
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11748
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11748
STATE LICENSE
TN
Enumeration date
04/19/2018
Last updated
04/19/2018
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