Individual
JACOB CHESNUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
785 CHICKAMAUGA AVE, ROSSVILLE, GA 30741-1477
(706) 866-1220
Mailing address
785 CHICKAMAUGA AVE, ROSSVILLE, GA 30741-1477
(706) 866-1220
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
23119
AL
183500000X
Pharmacist
Primary
RPH034675
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/14/2021
Last updated
06/11/2024
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