Individual
TOM LEE TATTERSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
5000 S 13TH ST, LEAVENWORTH, KS 66048-5581
(913) 727-4820
Mailing address
5417 WILLOW AVE, RAYTOWN, MO 64133-2843
(816) 737-1927
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
040881
MO
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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