Individual
DR. JESSICA IVY SOUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
240 MITCHELL BRIDGE RD, ATHENS, GA 30606-2043
(706) 850-4955
(706) 850-4958
Mailing address
240 MITCHELL BRIDGE RD, ATHENS, GA 30606-2043
(706) 850-4955
(706) 850-4958
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH031981
GA
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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