Individual
ALEXANDRA MARIA WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
5610 BETHELVIEW RD, CUMMING, GA 30040-7522
(470) 253-4893
Mailing address
5610 BETHELVIEW RD, CUMMING, GA 30040-7522
(470) 253-4893
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH029940
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH029940
GEORGIA STATE BOARD OF PHARMACY
GA
Enumeration date
07/26/2018
Last updated
07/26/2018
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