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Individual

JONATHAN SELLERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
104 TOWN BLVD NE, A100, BROOKHAVEN, GA 30319-3146
(404) 233-7475
Mailing address
104 TOWN BLVD NE, A100, BROOKHAVEN, GA 30319-3146
(404) 233-7475

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH026433
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RPH026433
GEORGIA BOARD OF PHARMACY
GA
Enumeration date
12/01/2014
Last updated
12/01/2014
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