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Individual

MR. JOHN KENNETH INGRAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
9591 CONNERS RD, VILLA RICA, GA 30180
(770) 456-9284
Mailing address
385 HARLAN RD SW, ATLANTA, GA 30311-2000
(770) 262-1868

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH020365
GA

Other

Enumeration date
09/27/2011
Last updated
09/27/2011
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