Individual
LISE B HENNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2175 PARKLAKE DR NE, ATLANTA, GA 30345-2845
(770) 496-7400
Mailing address
2175 PARKLAKE DR NE, ATLANTA, GA 30345-2845
(770) 496-7400
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14682
GA
Other
Enumeration date
04/16/2012
Last updated
04/16/2012
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