Individual
KAYLEE BEATY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1404 E JACKSON ST, THOMASVILLE, GA 31792-3937
(229) 225-1402
Mailing address
1404 E JACKSON ST, THOMASVILLE, GA 31792-3937
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH031102
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH031102
GEORGIA BOARD OF PHARMACY LICENSE
GA
Enumeration date
02/16/2019
Last updated
02/16/2019
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