Organization
LARRY J WHITEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY J WHITEN (OWNER)
(706) 886-5309
Entity
Organization
Contact information
Practice address
73 W DOYLE ST, TOCCOA, GA 30577-1787
(706) 886-5309
(706) 282-0168
Mailing address
73 W DOYLE ST, TOCCOA, GA 30577-1787
(706) 886-5309
(706) 282-0168
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
332BC3200X
GA
Other
Enumeration date
12/27/2007
Last updated
07/03/2008
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