Individual
BROOKE KUNZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
905 PARKSIDE WALK LN STE 108, LAWRENCEVILLE, GA 30043-7314
(770) 995-5911
Mailing address
4201 FONTANA CT, TUCKER, GA 30084-2218
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH031468
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH031468
GEORGIA BOARD OF PHARMACY
GA
Enumeration date
04/08/2021
Last updated
04/08/2021
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