Individual
RUSSELL PATRICK SEGRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
2175 PARKLAKE DR NE, ATLANTA, GA 30345-2845
(706) 363-2464
Mailing address
258 HUNTING HILLS DR, BRASELTON, GA 30517-5043
(678) 866-3306
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
019967
GA
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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