Individual
ISAAC MAISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 W PIKE ST, LAWRENCEVILLE, GA 30046-7699
(770) 339-1801
Mailing address
620 W PIKE ST, LAWRENCEVILLE, GA 30046-7699
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
030963
GA
Other
Enumeration date
11/28/2020
Last updated
11/28/2020
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