Individual
JON MACFADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
192 1ST AVE, EAST ELLIJAY, GA 30540-8101
(770) 635-2241
Mailing address
192 1ST AVE, EAST ELLIJAY, GA 30540-8101
(770) 635-2241
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH019421
GA
Other
Enumeration date
11/26/2015
Last updated
11/26/2015
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