Individual
DIANNE LODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6561 ESPALIER CIR, MEMPHIS, TN 38119-6648
(901) 759-4127
Mailing address
6561 ESPALIER CIR, MEMPHIS, TN 38119-6648
(901) 759-4127
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11481
TN
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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