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Micah Bowen Craine, PharmD

Pharmacist in Blaine, TN. Individual provider (NPI-1).

NPI number1003402652
StatusActive
Last updated in NPPESDec 17, 2020

Details

NPI
1003402652
Entity type
Individual (NPI-1)
Name
Micah Bowen Craine
Credential
PharmD
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 17, 2020
Certification date
Dec 17, 2020
Last updated
Dec 17, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist42059TNYes

Practice location

1050 Rutledge Pike
Blaine, TN 37709-3027

Phone 865-932-7775

Mailing address

1050 Rutledge Pike
Blaine, TN 37709-3027

Phone 865-932-7775

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