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General NPI Number Information
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NPI Number | 1780704254
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Entity Type | Individual
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Provider Name | MR. THOMAS ALLEN RAYMER
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Gender | Male
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2333 MCCALLIE AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37404-3258
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Country | US
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Telephone | 423-493-1728
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Fax | 423-493-1730
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Provider Business Mailing Address
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Address Line | 8720 CRESTBROOK CIR
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City | CHATTANOOGA
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State | TN
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Zip | 37421-6306
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Country | US
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Telephone | 423-894-1155
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Fax | 423-493-1730
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2236
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License Number State | TN
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