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Individual

MR. THOMAS RUCKER JETER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BS PHARM, RPH

Contact information

Practice address
1415 ROBERT E LEE LN, BRENTWOOD, TN 37027-6828
(770) 367-7766
Mailing address
1415 ROBERT E LEE LN, BRENTWOOD, TN 37027-6828
(770) 367-7766

Taxonomy

Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
0000042850
TN
1835G0303X
Geriatric Pharmacist
Primary
014305
GA
1835G0303X
Geriatric Pharmacist
37950
SC

Other

Enumeration date
12/04/2020
Last updated
12/04/2020
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