Individual
MR. ROOSEVELT N/A DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
(404) 327-4957
Mailing address
801 W PONCE DE LEON AVE, DECATUR, GA 30030-2859
(678) 296-5052
(404) 327-4957
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
014377
GA
Other
Enumeration date
06/28/2006
Last updated
07/08/2007
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