Individual
KRISHUNDRA CHONTAY MCKISSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3218 CYPRESS LAKE DR, MEMPHIS, TN 38119-8066
(901) 791-8567
Mailing address
3218 CYPRESS LAKE DR, MEMPHIS, TN 38119-8066
(901) 791-8567
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
450101080958554
TN
Other
Enumeration date
11/06/2021
Last updated
11/06/2021
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