Individual
JENNIFER BOURQUINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6995 CONCOURSE PKWY, DOUGLASVILLE, GA 30134-4551
(770) 489-3334
(770) 489-3616
Mailing address
3005 SHADE TREE CT, VILLA RICA, GA 30180-6957
(770) 456-4741
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH016809
GA
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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