Individual
MR. STEPHEN PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
225 LAZY HOLLOW LN, COVINGTON, GA 30016-4504
(631) 338-3478
Mailing address
225 LAZY HOLLOW LN, COVINGTON, GA 30016-4504
(631) 338-3478
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LPN088665
GA
347C00000X
Private Vehicle
Primary
—
GA
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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