Individual
MR. LARRY MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 RYE HILL DR, EVANS, GA 30809-5847
(706) 855-5195
(706) 731-7258
Mailing address
705 RYE HILL DR, EVANS, GA 30809-5847
(706) 855-5195
(706) 731-7258
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11406
GA
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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