Individual
MRS. AJELY SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
630 COLLINS HILL RD, LAWRENCEVILLE, GA 30046-4453
(770) 995-5212
Mailing address
3471 JIM MOORE RD, DACULA, GA 30019-1151
(919) 264-3365
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
023800
GA
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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