Individual
GLENDA LYNITA EVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
317 E HOBSON ST, SYLVESTER, GA 31791-3812
(229) 272-2284
Mailing address
317 E HOBSON ST, SYLVESTER, GA 31791-3812
(229) 272-2284
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
054361664
GA
Other
Enumeration date
05/16/2019
Last updated
05/16/2019
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