Individual
ASHENAFI MARIYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4600 E PONCE DE LEON AVE STE E, CLARKSTON, GA 30021-1839
(404) 500-1451
(678) 974-5383
Mailing address
4600 E PONCE DE LEON AVE STE E, CLARKSTON, GA 30021-1839
(404) 500-1451
(678) 974-5383
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH025437
GA
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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