Individual
JORDAN CHASE ILIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3050 WILMA RUDOLPH BLVD, CLARKSVILLE, TN 37040-5031
(931) 552-0241
Mailing address
3050 WILMA RUDOLPH BLVD, CLARKSVILLE, TN 37040-5031
(931) 552-0241
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
17214
KY
183500000X
Pharmacist
Primary
38240
TN
Other
Enumeration date
04/27/2018
Last updated
04/27/2018
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