Individual
KENNETH BRANT KICKLIGHTER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
111 E BARNARD ST, GLENNVILLE, GA 30427-1660
(912) 654-2184
Mailing address
111 E BARNARD ST, GLENNVILLE, GA 30427-1660
(912) 654-2184
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH25442
GA
Other
Enumeration date
05/14/2014
Last updated
05/16/2014
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