Individual
LIA CHURCHILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
409 S COLUMBIA AVE, RINCON, GA 31326-9080
(912) 826-7350
Mailing address
7 ASHLEIGH LN, POOLER, GA 31322-3921
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
026839
GA
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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