Provider Demographics
NPI:1952906869
Name:ROSENBALM, CHANDLER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHANDLER
Middle Name:
Last Name:ROSENBALM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11946 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:FARRAGUT
Mailing Address - State:TN
Mailing Address - Zip Code:37934-4601
Mailing Address - Country:US
Mailing Address - Phone:865-966-6987
Mailing Address - Fax:
Practice Address - Street 1:11946 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:FARRAGUT
Practice Address - State:TN
Practice Address - Zip Code:37934-4601
Practice Address - Country:US
Practice Address - Phone:865-966-6987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist