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Individual

DR. CHARLIE JOE BURSE III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPH

Contact information

Practice address
1485 WOODSIDE DR, LEBANON, TN 37087
(901) 409-4167
Mailing address
1485 WOODSIDE DR, LEBANON, TN 37087-8701
(901) 409-4167

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8037
TN

Other

Enumeration date
05/13/2013
Last updated
05/13/2013
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