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Individual

JACOB BOATENG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
736 W BANKHEAD HWY, VILLA RICA, GA 30180-1501
(770) 459-8234
Mailing address
6434 SHADOW CT, DOUGLASVILLE, GA 30134-1412
(770) 861-4545

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH034064
GA

Other

Enumeration date
01/09/2023
Last updated
01/09/2023
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