Individual
AMY BARTLEY BURGHARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2730 HIGHWAY 155, LOCUST GROVE, GA 30248-2401
(770) 288-4186
Mailing address
1260 MCALLISTAR DR, LOCUST GROVE, GA 30248-2480
(770) 898-6740
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
021699
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021699
GA STATE BOARD OF PHARMACY
GA
Enumeration date
01/23/2013
Last updated
01/23/2013
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