Individual
SY LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD, BCPS
Contact information
Practice address
891 CHANNEL DR, LAWRENCEVILLE, GA 30046-8480
(678) 549-5210
Mailing address
891 CHANNEL DR, LAWRENCEVILLE, GA 30046-8480
(678) 549-5210
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
RPH026734
GA
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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