Individual
JANA ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 LANNY BRIDGES AVE, COVINGTON, TN 38019-1615
(901) 476-4648
Mailing address
PO BOX 644, COLLIERVILLE, TN 38027-0644
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8915
TN
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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