Individual
MITCHELL HARDESTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
780 GLYNN ST N, FAYETTEVILLE, GA 30214-1193
(770) 716-2262
Mailing address
136 1ST AVE, GRIFFIN, GA 30223-1748
(770) 905-1855
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PHTC038176
GA
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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