Individual
JESSICA LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
150 S LEROY ST, METTER, GA 30439-4631
(912) 685-2803
Mailing address
209 BOYD DR, RICHMOND HILL, GA 31324-4160
(912) 660-8590
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
239126
GA
183500000X
Pharmacist
Primary
032314
GA
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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