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MICHELLE LEDESMA GLISSON

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1598922288

Individual Registrant:
 MICHELLE LEDESMA GLISSON 
Gender: F
Sole Proprietor

Location and contact information for practice:
114 W BARNARD ST  GLENNVILLE, GA 30427-2000 US
Tel: 912-654-3031  Fax: --

Contact information for business:
PO BOX 104 377 TUCKER RD CLAXTON, GA 30417-0104 US
Tel: 912-739-3822  Fax: --

Registration Information:
NPI: 1598922288
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
GA18775

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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