Individual
MRS. CAROL HARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4110 HARDAWAY RD, ALBANY, GA 31705-8746
(229) 869-3094
Mailing address
PO BOX 156, PUTNEY, GA 31782-0156
(229) 869-3094
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171W00000X
—
GA
Enumeration date
09/19/2016
Last updated
09/19/2016
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