Individual
LI TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
415 N LINCOLN BLVD, HODGENVILLE, KY 42748-1610
(270) 358-3186
Mailing address
110B RALEIGH DR, ELIZABETHTOWN, KY 42701-7139
(917) 250-0126
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
022157
KY
Other
Enumeration date
08/09/2021
Last updated
11/20/2022
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