Individual
JORDAN ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
851 S SHADY ST, MOUNTAIN CITY, TN 37683-1831
(423) 727-1210
Mailing address
606 SWADLEY RD APT 23, JOHNSON CITY, TN 37601-9017
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
29171
NC
183500000X
Pharmacist
Primary
43359
TN
Other
Enumeration date
06/10/2020
Last updated
06/10/2020
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