Austin Lively, RPH

NPI #1851849657 in Fairburn, Georgia

Provider Information

NPI Number: 1851849657
Entity Type: Individual
Name: Austin Lively, RPH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Sep 21, 2016
Last Updated: Sep 21, 2016

Practice Location

Address: 5370 CAMPBELLTON FAIRBURN RD
City: Fairburn
State: Georgia
ZIP Code: 30213-2296
Phone: (770) 774-3605

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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