Individual
DR. HEATHER ASHLEE FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
502 BOOTH RD, WARNER ROBINS, GA 31088-3422
(478) 918-0678
(478) 918-0675
Mailing address
1123 ALDERLY LN, WARNER ROBINS, GA 31088-2221
(573) 586-6964
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
031295
GA
183500000X
Pharmacist
2007025733
MO
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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