Individual
JORDAN EDWARD ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
395 NORTH AVE, ATHENS, GA 30601-2245
(708) 546-6627
Mailing address
700 MITCHELL BRIDGE RD APT 137, ATHENS, GA 30606-6417
(404) 731-2392
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-029248
GA
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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