Individual
MR. KENNETH GENE SOUDER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
402 BEMBERG RD, ELIZABETHTON, TN 37643-2938
(423) 543-3493
(423) 534-5493
Mailing address
1525 ROBIN HOOD LN, JOHNSON CITY, TN 37604-3702
(423) 360-3679
(423) 283-4198
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3344
TN
Other
Enumeration date
11/17/2005
Last updated
07/08/2007
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