Individual
JERRY WAYNE OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
527 LAKE ST, HAZLEHURST, MS 39083-2217
(601) 894-1476
Mailing address
560 WHITE OAK RD, FLORENCE, MS 39073-4022
(601) 201-8526
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E7659
MS
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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