Individual
JACKSON WOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
911 DULUTH HWY, LAWRENCEVILLE, GA 30043-5320
(770) 339-5606
Mailing address
911 DULUTH HWY, LAWRENCEVILLE, GA 30043-5320
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH031547
GA
Other
Enumeration date
08/24/2019
Last updated
08/24/2019
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