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Individual

JOHN THOMAS LAZENBY III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMACIST

Contact information

Practice address
3807 CLAIRMONT RD, CHAMBLEE, GA 30341-4911
(770) 457-6236
(770) 451-8018
Mailing address
998 WILLIAMS MILL RD NE, ATLANTA, GA 30306-4431
(770) 457-6237
(770) 451-8018

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
012692
GA

Other

Enumeration date
04/04/2007
Last updated
07/08/2007
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