Individual
MR. JONATHAN MARC BRANTLEY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2705 BUFORD HWY, DULUTH, GA 30096-2833
(770) 476-5363
(770) 476-7695
Mailing address
2705 BUFORD HWY, DULUTH, GA 30096-2833
(770) 476-5363
(770) 476-7695
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH018694
GA
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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