Individual
ERICA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 LOWER FAYETTEVILLE RD, NEWNAN, GA 30265-6501
(770) 502-2376
Mailing address
1111 LOWER FAYETTEVILLE RD, NEWNAN, GA 30265-6501
(770) 502-2376
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH027338
GA
Other
Enumeration date
09/11/2013
Last updated
09/11/2013
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