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Individual

MR. JOSEPH DANIEL-BAILEY FERNANDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPHT

Contact information

Practice address
118 RIDGEVIEW CT, PEACHTREE CITY, GA 30269-1533
(770) 584-2755
Mailing address
130 PEACHTREE EAST SHOPPING CTR, PEACHTREE CITY, GA 30269-4045
(770) 468-2026

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
500107010023466
GA
183700000X
Pharmacy Technician
Primary
PHTC003567
GA

Other

Enumeration date
02/04/2013
Last updated
02/04/2013
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