Individual
ANTONIO MCROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1011 UNION ST, OCILLA, GA 31774-3813
(229) 425-7445
Mailing address
1011 UNION ST, OCILLA, GA 31774-3813
(229) 425-7445
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
050400538
GA
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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