Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Jan 30, 2012
License(s)
RPH022864 (GA), PH26339 (MA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 93065 | Atlanta, GA 30377-0065 | |
| LOCATION | 422 WALNUT ST | Hapeville, GA 30354-1235 | 770-906-6389 |
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