Individual
DEEPA E CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4235 LAWRENCEVILLE HWY, LILBURN, GA 30047
(770) 921-7074
(770) 921-7083
Mailing address
4235 LAWRENCEVILLE HWY, LILBURN, GA 30047
(770) 921-7074
(770) 921-7083
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH023873
GA
Other
Enumeration date
09/30/2011
Last updated
09/30/2011
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