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Individual

MR. BRANDALL LOVVORN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH. PHARMD

Contact information

Practice address
404 ALABAMA AVE S, BREMEN, GA 30110-2006
(770) 537-8889
(770) 537-8817
Mailing address
PO BOX 603, BREMEN, GA 30110-0603
(770) 537-8889
(770) 537-8817

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8702
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00977479A
GA
Enumeration date
07/11/2006
Last updated
07/08/2007
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