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1427396035
CLETUS AHIDJO FOMA
LAWRENCEVILLE, GA
NPI
1427396035
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: GA RPH024164)
Enumeration Date
2013-01-17
Last Update Date
2021-02-01
Business Address
CLETUS AHIDJO FOMA PHARMACIST
2935 FIVE FORKS TRICKUM RD
LAWRENCEVILLE, GA 30044-5895
Phone number: 770-982-5202
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Mailing Address
CLETUS AHIDJO FOMA PHARMACIST
2412 CHANCE LN
GRAYSON, GA 30017-7867
Phone number: 678-793-6496
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