Individual
DR. EDWIN SELF IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
201 WALMART DR, EATONTON, GA 31024-6761
(706) 485-4546
Mailing address
307 CARRIAGE WAY, EATONTON, GA 31024-1303
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH028443
GA
Other
Enumeration date
04/14/2022
Last updated
04/14/2022
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