Individual
BRENTON CARTER LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1120 15TH ST, 2ND FLOOR, ROOM BT2601, AUGUSTA, GA 30912-0004
(706) 446-1234
(706) 721-9505
Mailing address
1215 PEACHTREE RD, AUGUSTA, GA 30909-3821
(706) 446-1234
(706) 721-9505
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0024272
GA
183500000X
Pharmacist
12567
SC
Other
Enumeration date
01/10/2013
Last updated
12/17/2015
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