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General NPI Number Information
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NPI Number | 1639298607
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Entity Type | Individual
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Provider Name | RALPH CLAYTON ALLEY R.PH.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 10/15/2010
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Provider Practice Location Address
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Address Line | 5915 SPOUT SPRINGS RD
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City | FLOWERY BRANCH
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State | GA
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Zip | 30542-4005
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Country | US
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Telephone | 770-967-1664
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Fax | 770-967-1955
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Provider Business Mailing Address
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Address Line | 6117 ALLEE WAY
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City | BRASELTON
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State | GA
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Zip | 30517-6033
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Country | US
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Telephone | 770-364-2812
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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 | 0011768
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License Number State | GA
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