Individual
DOMINIQUE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
450 NORTHSIDE CHEROKEE BLVD, CANTON, GA 30115-8015
(770) 224-1200
Mailing address
2155 CHADWICK DR, CUMMING, GA 30028-8118
(678) 776-3309
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH028142
GA
Other
Enumeration date
04/30/2022
Last updated
04/30/2022
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