Individual
JAMES LARRY BOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
517 LESLIE DR, VILLA RICA, GA 30180-2406
(770) 459-5179
Mailing address
517 LESLIE DR, VILLA RICA, GA 30180-2406
(770) 459-5179
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
009437
GA
Other
Enumeration date
05/02/2007
Last updated
12/14/2007
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