Individual
GLEN PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
83 CACTUS TRL, HORTENSE, GA 31543-2544
(912) 294-6637
Mailing address
6586 HWY 40, SAINT MARYS, GA 31558-4039
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH030914
GA
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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