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Individual

MICHAEL FAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
3605 BRAINERD RD, CHATTANOOGA, TN 37411-3602
(423) 622-7520
Mailing address
220 CITYGREEN WAY APT 302, CHATTANOOGA, TN 37405-1481
(480) 639-9664

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000043251
TN
183500000X
Pharmacist
S024045
AZ

Other

Enumeration date
09/01/2019
Last updated
09/01/2019
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