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Individual

MRS. HEATHER RIDGWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
111 ALTAMONT AVE, DALTON, GA 30720-5910
(843) 810-8545
Mailing address
PO BOX 6434, DALTON, GA 30722-6434
(843) 810-8545

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHI-017889
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PHI-017889
DEPARTMENT OF HEALTH
GA
Enumeration date
01/21/2015
Last updated
01/21/2015
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