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Individual

BRUCE LEE INGMIRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
14860 HIGHLAND DR, MC KENZIE, TN 38201-2606
(731) 352-7744
(731) 352-5083
Mailing address
14860 HIGHLAND DR, MC KENZIE, TN 38201-2606
(731) 352-7744

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26011
TN

Other

Enumeration date
02/28/2011
Last updated
02/28/2011
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