Individual
MR. CLARENCE RHEA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
230 LONG HOLLOW PIKE, GOODLETTSVILLE, TN 37072-1880
(615) 859-3498
(615) 855-2112
Mailing address
230 LONG HOLLOW PIKE, GOODLETTSVILLE, TN 37072-1880
(615) 859-3498
(615) 855-2112
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1870
TN
Other
Enumeration date
02/19/2010
Last updated
02/19/2010
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