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General NPI Number Information
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NPI Number | 1497245914
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Entity Type | Individual
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Provider Name | EMILY BROOKE WITTWER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 05/10/2018
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Provider Practice Location Address
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Address Line | 220 HIGHWAY 334
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City | COMMERCE
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State | GA
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Zip | 30530-4835
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Country | US
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Telephone | 706-335-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 900 MCKENDREE LN
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City | BETHLEHEM
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State | GA
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Zip | 30620-2646
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Country | US
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Telephone | 678-863-8410
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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 | RPH028559
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License Number State | GA
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