Individual
LANCE WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1310 24TH AVE S, NASHVILLE, TN 37212-2637
(615) 327-4751
(615) 321-6350
Mailing address
2117 VICTORY GALLOP LN, MURFREESBORO, TN 37128-8265
(615) 818-7288
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0000038444
TN
Other
Enumeration date
07/19/2013
Last updated
07/19/2013
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