Most Relevant Information
Provider Data
| NPI Number: | 1003428194 |
| Provider Name: | JORDAN KYLE RICHARDSON |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 41424 |
Most Important Dates
| Enumeration Date: | 08/19/2020 |
| Last Updated: | 08/19/2020 |
Provider Practice Location
1650 E ANDREW JOHNSON HWY
GREENEVILLE
TN
377454274
Practice Location Phone/Fax
| Phone: | 4236384889 |
| Fax: |
Provider Mailing Location
1650 E ANDREW JOHNSON HWY
GREENEVILLE
TN
377454274
Provider Mailing Phone/Fax
| Phone: | 4236384889 |
| Fax: |