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Individual

MRS. LISA G MCDONALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RPH, CDM

Contact information

Practice address
528 SPARTA RD, SANDERSVILLE, GA 31082-1859
(478) 552-6114
(478) 552-6119
Mailing address
528 SPARTA RD, SANDERSVILLE, GA 31082-1859
(478) 552-6114
(478) 552-6119

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
017231
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
017231
STATE PHARMACIST'S LICENS
GA
Enumeration date
12/26/2006
Last updated
07/08/2007
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