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1184376212
LOGAN RUSSELL HENDERSON
MARIETTA, GA
NPI
1184376212
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: GA RPH028870)
Enumeration Date
2022-01-20
Last Update Date
2022-01-20
Business Address
Dr. LOGAN RUSSELL HENDERSON PharmD
790 CHURCH ST NE STE 210
MARIETTA, GA 30060-8950
Phone number: 770-424-3131
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Mailing Address
Dr. LOGAN RUSSELL HENDERSON PharmD
790 CHURCH ST NE STE 210
MARIETTA, GA 30060-8950
Phone number: 770-424-3131
Copy
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