Individual
MR. DARRYL STOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
4637 HICKS RD SW, MABLETON, GA 30126-1333
(770) 819-9177
Mailing address
4637 HICKS RD SW, MABLETON, GA 30126-1333
(770) 819-9177
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
009459
GA
Other
Enumeration date
04/18/2011
Last updated
04/18/2011
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