Individual
MR. GEORGE ROBERT REA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
108 HIGHWAY 12 E, KOSCIUSKO, MS 39090-3304
(662) 289-1963
Mailing address
11765 HIGHWAY 35 N, KOSCIUSKO, MS 39090-4870
(601) 650-8838
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-06345
MS
Other
Enumeration date
01/20/2021
Last updated
01/20/2021
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