Individual
JILL OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 HOLCOMB BRIDGE RD, ROSWELL, GA 30076-3481
(678) 352-7480
(678) 352-7483
Mailing address
2300 HOLCOMB BRIDGE RD, ROSWELL, GA 30076-3481
(678) 352-7480
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
17467
AL
183500000X
Pharmacist
Primary
RPH-027290
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17467
PHARMACIST LICENSE NUMBER
AL
Enumeration date
10/29/2014
Last updated
10/14/2020
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