Individual
ELLISON BROWN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7363 GOODMAN RD, OLIVE BRANCH, MS 38654-1906
(662) 890-7555
Mailing address
7363 GOODMAN RD, OLIVE BRANCH, MS 38654-1906
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
41588
TN
183500000X
Pharmacist
Primary
E-15036
MS
Other
Enumeration date
11/30/2020
Last updated
12/07/2020
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