Organization
LAKEWAY PHARMACY CONSULTANTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARROD VICK PHARMD (AO)
(423) 720-9777
Entity
Organization
Contact information
Practice address
136 E BROADWAY, NEWPORT, TN 37821-2323
(423) 720-9777
Mailing address
136 E BROADWAY, NEWPORT, TN 37821-2323
(423) 720-9777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/18/2023
Last updated
10/24/2023
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