Individual
WEST WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18741 US HIGHWAY 129, ABBEVILLE, GA 31001-1982
(478) 867-2943
Mailing address
18741 US HIGHWAY 129, ABBEVILLE, GA 31001-1982
(478) 867-2943
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
RPH020921
GA
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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