Individual
DR. ALISE NICOLE JETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1861 ROANOKE RD STE A, LAGRANGE, GA 30240-3850
(706) 350-4200
(706) 350-4220
Mailing address
1861 ROANOKE RD STE A, LAGRANGE, GA 30240-3850
(706) 350-4200
(706) 350-4220
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH029766
GA
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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