-- KYLE OTIS ALVIN --
Individual Provider (NPI-1)
Active
Pharmacy, Community/Retail Pharmacy
Provider Information
- NPI Number
1528939220- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1140 N HAIRSTON RD, STONE MOUNTAIN, GA, 300835800
- Phone
- (404) 292-0484
Specialties & Taxonomies
Pharmacy, Community/Retail Pharmacy
Primary License: GA #RPH035846