Individual
JENNIFER ROSE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1703 W MAIN ST, LEBANON, TN 37087-3186
(615) 444-3576
Mailing address
4155 MAGNOLIA FARMS DR, HERMITAGE, TN 37076-1638
(615) 294-2314
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
44141
TN
Other
Enumeration date
06/29/2020
Last updated
09/11/2024
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