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Individual

JARED ALAN LOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
303 CHARLIE WATTS BLVD, DALLAS, GA 30157
(770) 443-4886
(770) 443-5904
Mailing address
303 CHARLIE WATTS BLVD, DALLAS, GA 30157
(770) 443-4886
(770) 443-5904

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH020494
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1161568
NABP
GA
01
1386930071
NPI
Enumeration date
10/15/2011
Last updated
10/15/2011
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