Individual
DR. GRETCHEN LICUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD, RPH
Contact information
Practice address
5095 MOUNT ZION PKWY, STOCKBRIDGE, GA 30281-7825
(404) 884-9498
Mailing address
5095 MOUNT ZION PKWY, STOCKBRIDGE, GA 30281-7825
(404) 884-9498
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH034244
GA
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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