Individual
SHAUN MICHAEL WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4767 HIGHWAY 58, CHATTANOOGA, TN 37416-2282
(678) 670-0967
Mailing address
7201 SYLVIA TRL, CHATTANOOGA, TN 37421-4062
(678) 670-0967
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
74465
TN
Other
Enumeration date
12/14/2021
Last updated
12/14/2021
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