Individual
MRS. JENNIFER DIONNE BROADWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
6263 ROBINS TRCE, STONE MOUNTAIN, GA 30087-6537
(770) 469-9795
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS29599
FL
Other
Enumeration date
06/29/2006
Last updated
07/08/2007
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