Individual
MR. WILBUR T. LITTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
141 PALISADE POINT DR., ELLENWOOD, GA 30294
(404) 386-7270
Mailing address
141 PALISADE POINT DR, ELLENWOOD, GA 30294-4528
(404) 386-7270
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870757549
—
GA
Enumeration date
06/10/2009
Last updated
06/10/2009
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