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General NPI Number Information
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NPI Number | 1174991400
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Entity Type | Individual
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Provider Name | WENDY DRY
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Gender | Female
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Dates
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Enumeration Date | 09/03/2015
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 4890 CHEROKEE ST
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City | ACWORTH
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State | GA
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Zip | 30101-4902
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Country | US
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Telephone | 678-458-9290
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Fax |
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Provider Business Mailing Address
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Address Line | 862 LENOX OAKS CIR NE
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City | ATLANTA
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State | GA
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Zip | 30324-2839
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Country | US
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Telephone | 706-207-0626
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH028419
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License Number State | GA
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