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General NPI Number Information
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NPI Number | 1720324395
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Entity Type | Individual
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Provider Name | JENNA LAINE DAILEY PHARM D
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Gender | Female
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Dates
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Enumeration Date | 12/29/2012
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Last Update Date | 12/29/2012
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Provider Practice Location Address
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Address Line | 400 S LIBERTY ST
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City | WAYNESBORO
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State | GA
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Zip | 30830-1501
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Country | US
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Telephone | 706-437-7977
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Fax |
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Provider Business Mailing Address
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Address Line | 3388 RECREATION DR
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City | MILLEN
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State | GA
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Zip | 30442-3407
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Country | US
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Telephone | 478-982-1173
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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 | RPH026914
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License Number State | GA
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