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Individual

LISA CARR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
113 AMBLESIDE DR, LEESBURG, GA 31763-5346
(229) 395-0302
Mailing address
113 AMBLESIDE DR, LEESBURG, GA 31763-5346
(229) 395-0302

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19406
GA
183500000X
Pharmacist
8748
SC
183500000X
Pharmacist
PS29563
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
328347
NABP
Enumeration date
12/01/2014
Last updated
12/01/2014
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