Individual
CHERIE FONTENOT MIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
1620 CENTURY CENTER PKWY, SUITE 109, MEMPHIS, TN 38134-0181
(901) 381-7400
Mailing address
1790 BEKAH RD, GERMANTOWN, TN 38138-2802
(901) 605-8007
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000008331
TN
Other
Enumeration date
03/10/2010
Last updated
03/10/2010
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