Individual
MR. JIMMY DERRELL MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5337 TAMMY LITTLE DR, SECTION, AL 35771-7206
(256) 228-7179
Mailing address
PO BOX 29, SECTION, AL 35771-0029
(256) 228-6443
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10177
AL
Other
Enumeration date
03/31/2006
Last updated
07/08/2007
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