Individual
AQUILA INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7300 GA HIGHWAY 21, SAVANNAH, GA 31407-9205
(912) 964-1791
Mailing address
6205 ALTA TOWNE LAKE CIR, POOLER, GA 31322-5070
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH14338
SC
Other
Enumeration date
08/26/2013
Last updated
08/26/2013
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