Organization
ANTI AGING CONCEPTS, LLC
Active
Other names
Professional Pharmacy Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY RAYFORD KEEL DPH (CHIEF MANAGER)
(423) 892-8635
Entity
Organization
Contact information
Practice address
1510 GUNBARREL RD, SUITE 700, CHATTANOOGA, TN 37421-7174
(423) 892-8635
(423) 892-8106
Mailing address
1510 GUNBARREL RD, SUITE 700, CHATTANOOGA, TN 37421-7174
(423) 892-8635
(423) 892-8106
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
4141
TN
3336C0003X
Community/Retail Pharmacy
Primary
4141
TN
Other
Enumeration date
01/29/2007
Last updated
04/29/2008
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