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Individual

THERESA ANN BETTEKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1021 STONEKIRK TRCE, LAWRENCEVILLE, GA 30043-2666
(770) 995-2481
(770) 586-5101
Mailing address
1021 STONEKIRK TRCE, LAWRENCEVILLE, GA 30043-2666
(770) 995-2481
(770) 586-5101

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
020021
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
020021
GA
Enumeration date
06/26/2008
Last updated
06/26/2008
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