Individual
DR. JASON LEE WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
11509 ABERCORN ST, SAVANNAH, GA 31419-1901
(912) 927-6119
Mailing address
1013 TRAFFORD LN, SAVANNAH, GA 31410-5115
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH026369
GA
Other
Enumeration date
11/16/2011
Last updated
11/20/2011
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