Individual
JEFFREY RAKESTRAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
457 NATHAN DEAN BLVD, DALLAS, GA 30132-4911
(770) 443-8776
Mailing address
457 NATHAN DEAN BLVD, DALLAS, GA 30132-4911
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
016922
GA
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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