Individual
JILL SHALLENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1727 MARS HILL RD NW, ACWORTH, GA 30101-8090
(770) 218-2426
Mailing address
254 SHERATON WAY, DALLAS, GA 30132-2383
(770) 856-6740
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH035037
GA
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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