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Individual

MR. JOE W PENNINGTON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
57 GRANADE ST, STATESBORO, GA 30458-5106
(912) 764-5643
(912) 764-9580
Mailing address
417 MAGNOLIA BLF, STATESBORO, GA 30461-4216

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
016161
GA

Other

Enumeration date
10/07/2005
Last updated
07/08/2007
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