Individual
JESSI EASTERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 1ST ST STE 415, MACON, GA 31201-8300
(478) 743-7068
Mailing address
2235 GLENWOOD AVE SE, ATLANTA, GA 30316-2307
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
RPH030152
GA
Other
Enumeration date
08/24/2017
Last updated
01/06/2021
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