Individual
BERTUKAN WORKU DEMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3671 COBBLE MILL LN, CLARKSTON, GA 30021
(404) 281-0647
Mailing address
3671 COBBLE MILL LN, CLARKSTON, GA 30021
(404) 281-0647
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202214677
VA
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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