Individual
MIRANDA DESIREE BAUMGARTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT-ADV, CSPT
Contact information
Practice address
1 7TH ST STE 107, AUGUSTA, GA 30901-1305
(706) 855-0155
Mailing address
210 AMELIA DR W, MARTINEZ, GA 30907-9373
(256) 727-2765
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PHTC051881
GA
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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