Individual
LATE MADJE LAWSON-BODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
22 UPPER RIVERDALE RD SE, RIVERDALE, GA 30274-2620
(770) 472-4566
Mailing address
22 UPPER RIVERDALE RD SE, RIVERDALE, GA 30274-2620
(770) 472-4566
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH028140
GA
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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