Individual
DR. EDITH UCHE LIVINUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
773 HIGHWAY 138 SW, SUITE 13, RIVERDALE, GA 30296-1599
(770) 461-9015
Mailing address
160 MOSS CREEK WALK, FAYETTEVILLE, GA 30214-2692
(404) 246-2166
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH022522
GA
1835N1003X
Nutrition Support Pharmacist
RPH022522
GA
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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