Individual
JEFF VIKTORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
824 GI MADDOX PKWY, SUITE B, CHATSWORTH, GA 30705-2073
(706) 517-1901
Mailing address
212 GLENBROOK LN, CANTON, GA 30115-7086
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH020566
GA
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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