Individual
MR. GEORGE TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
100 CLEVELAND ST, ELYRIA, OH 44035-6138
(440) 322-7604
Mailing address
1008 CHIPPEWA ST, GRAFTON, OH 44044-1218
(440) 452-4797
(440) 322-9035
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03223121
OH
Other
Enumeration date
09/19/2011
Last updated
09/19/2011
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