Individual
DAMALI AIDA HEPBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
2465 KALEY WALK NW, KENNESAW, GA 30152-3015
(770) 714-4784
Mailing address
2465 KALEY WALK NW, KENNESAW, GA 30152-2684
(770) 714-4784
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202208696
VA
Other
Enumeration date
11/06/2018
Last updated
11/06/2018
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