Individual
JIMMY MIKE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 MEDICAL PARK DR, POOLER, GA 31322-1956
(912) 748-3194
Mailing address
80 ISLAND VIEW CT, RICHMOND HILL, GA 31324-6015
(912) 727-3010
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14254
GA
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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