Individual
DR. LACEY MONGRUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3527 RIVER WATCH PKWY, AUGUSTA, GA 30907-2919
(706) 210-0091
(706) 228-5260
Mailing address
3527 RIVER WATCH PKWY, AUGUSTA, GA 30907-2919
(706) 210-0091
(706) 228-5260
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH027259
GA
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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