Individual
ALLAN VAN SHUPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1733 POWDER SPRINGS RD SW, MARIETTA, GA 30064-4863
(770) 427-6724
(770) 919-8610
Mailing address
1733 POWDER SPRINGS RD SW, MARIETTA, GA 30064-4863
(770) 427-6724
(770) 919-8610
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
011542
GA
Other
Enumeration date
02/21/2011
Last updated
02/21/2011
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