Individual
JAY VANSICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2151 N CHARLES G SEIVERS BLVD, CLINTON, TN 37716-6749
(865) 457-1377
Mailing address
2151 N CHARLES G SEIVERS BLVD, CLINTON, TN 37716-6749
(865) 457-1377
(865) 457-1327
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
43678
TN
Other
Enumeration date
08/14/2020
Last updated
08/14/2020
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