Individual
MR. CARTER DALE BRANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
62 INDUSTRIAL BLVD, VILLA RICA, GA 30180-1545
(770) 459-9660
Mailing address
5650 TOCCOA DR, DOUGLASVILLE, GA 30135-5803
(770) 949-7418
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
011568
GA
Other
Enumeration date
04/14/2011
Last updated
04/14/2011
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