Individual
JERRY MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
123 W HIGHWAY 25 70, DANDRIDGE, TN 37725-6401
(865) 484-0263
(865) 424-0769
Mailing address
PO BOX 332, DANDRIDGE, TN 37725-0332
(865) 484-0263
(865) 484-0769
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10422
TN
Other
Enumeration date
03/14/2015
Last updated
03/14/2015
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