Individual
CHANTHAKHONE JUAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
575 DACULA RD, DACULA, GA 30019-2125
(305) 254-0323
Mailing address
575 DACULA RD, DACULA, GA 30019-2125
(770) 962-2077
(770) 962-2171
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PS42653
FL
183500000X
Pharmacist
Primary
RPH032388
GA
Other
Enumeration date
10/03/2016
Last updated
12/21/2022
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