Individual
MR. JESSIE CARL DANIELS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
207 SUNSET LN, CAIRO, GA 39828-6741
(229) 378-8922
Mailing address
207 SUNSET LN, CAIRO, GA 39828-6741
(229) 378-8922
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
019429298
GA
Other
Enumeration date
05/05/2011
Last updated
05/05/2011
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