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Individual

LARRY DANIEL DENSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3100 RANLO DR, DORAVILLE, GA 30340-4614
(770) 414-4812
Mailing address
3100 RANLO DR, DORAVILLE, GA 30340-4614
(770) 414-4812

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
208080
SC

Other

Enumeration date
06/29/2010
Last updated
06/29/2010
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