Individual
PROF. MARK MONTEROLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1462 MONTREAL RD, TUCKER, GA 30084-6929
(770) 934-0000
Mailing address
1462 MONTREAL RD, TUCKER, GA 30084-6929
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PHTC001834
GA
Other
Enumeration date
02/12/2013
Last updated
05/24/2013
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