Individual
MR. BEVERLY H TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
132 W JACKSON ST, DUBLIN, GA 31021-6116
(478) 272-1822
Mailing address
908 RAILROAD AVE E, SOPERTON, GA 30457-1247
(912) 529-6693
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12039
GA
Other
Enumeration date
08/23/2006
Last updated
07/08/2007
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