Individual
ERICA AWALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
905 MEMORIAL DR SE, ATLANTA, GA 30316-1434
(404) 460-9269
Mailing address
4354 SASANQUA CT, TUCKER, GA 30084-6263
(770) 344-8209
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH033332
GA
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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