MR. Vincent Albert Destasio JR., RPH

NPI #1841573185 in Canton, Georgia

Provider Information

NPI Number
1841573185
Entity Type
Individual
Name
MR. Vincent Albert Destasio JR., RPH
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Pharmacist
Credential
RPH
Enumeration Date
Sep 22, 2011
Last Updated
Sep 22, 2011

Practice Location

Address
6111 HICKORY FLAT HWY
City
Canton
State
Georgia
ZIP Code
30115-7253
Phone
(770) 479-7039

Specialties & Taxonomy Codes

Specialty
Pharmacist

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