Individual
EDITH EZEAGWU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6690 HIGHWAY 85, RIVERDALE, GA 30274-2376
(770) 997-7494
Mailing address
150 BRAMBLEBUSH CHASE, FAYETTEVILLE, GA 30214-2670
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
018594
GA
Other
Enumeration date
03/23/2011
Last updated
03/23/2011
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