Individual
DR. ANDREA SPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2050 W SPRING ST, MONROE, GA 30655-3164
(770) 267-4175
(770) 267-3071
Mailing address
2050 W SPRING ST, MONROE, GA 30655-3164
(770) 267-4175
(770) 267-3071
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH023647
GA
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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