Individual
DR. COREY RICHARD SLACKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5401 FAIRINGTON RD, LITHONIA, GA 30038-5113
(770) 598-4998
Mailing address
2404 CAVALIER XING, LITHONIA, GA 30038-5325
(229) 425-6058
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH031069
GA
Other
Enumeration date
10/31/2020
Last updated
10/31/2020
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