Individual
MR. BOB WANSLEY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4104 TATE ST, COVINGTON, GA 30014
(770) 786-2284
(770) 786-2285
Mailing address
8173 MONTICELLO ST, COVINGTON, GA 30014
(770) 787-3478
(770) 786-2285
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10515
GA
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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