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Individual

MR. BRUCE JOHNSON PATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPH.

Contact information

Practice address
700 E REELFOOT AVE, UNION CITY, TN 38261-5804
(731) 884-1223
(731) 884-3859
Mailing address
700 E REELFOOT AVE, UNION CITY, TN 38261-5804
(731) 884-1223
(731) 884-3859

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6107
TN

Other

Enumeration date
09/30/2011
Last updated
09/30/2011
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