Individual
DR. AUSTIN BLAKE FULWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
880 MADISON AVE, MEMPHIS, TN 38103-3409
(901) 545-7970
Mailing address
10233 EVERGREEN MANOR CV, LAKELAND, TN 38002-1080
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
43362
TN
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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