Individual
LAURA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
4120 AUSTELL RD, AUSTELL, GA 30106-1841
(770) 941-2918
Mailing address
4120 AUSTELL RD, AUSTELL, GA 30106-1841
(770) 941-2918
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RP043860L
PA
183500000X
Pharmacist
Primary
RPH023834
GA
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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