Individual
MARK CORUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1212 STATE ST, WHITE PINE, TN 37890-3467
(865) 674-7517
Mailing address
868 SELLERS RD, JEFFERSON CITY, TN 37760-4203
(865) 591-6942
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9174
TN
Other
Enumeration date
03/18/2015
Last updated
03/18/2015
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