Individual
JARET THACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
563 BRIGHAM TRL, AUGUSTA, GA 30909-6060
(803) 421-9777
Mailing address
563 BRIGHAM TRL, AUGUSTA, GA 30909-6060
(803) 421-9777
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH 35781
SC
183500000X
Pharmacist
RPH028114
GA
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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