Most Relevant Information
Provider Data
| NPI Number: | 1003402652 |
| Provider Name: | MICAH BOWEN CRAINE PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 42059 |
Most Important Dates
| Enumeration Date: | 12/17/2020 |
| Last Updated: | 12/17/2020 |
Provider Practice Location
1050 RUTLEDGE PIKE
BLAINE
TN
377093027
Practice Location Phone/Fax
| Phone: | 8659327775 |
| Fax: |
Provider Mailing Location
1050 RUTLEDGE PIKE
BLAINE
TN
377093027
Provider Mailing Phone/Fax
| Phone: | 8659327775 |
| Fax: |