Individual
LANNY R PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
339 HIGHWAY 321, HAMPTON, TN 37658-3277
(423) 725-2327
Mailing address
PO BOX 314, HAMPTON, TN 37658-0314
(423) 725-4175
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6121
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4433859
—
TN
Enumeration date
06/30/2006
Last updated
07/09/2007
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