Individual
MR. KENNETH JAMES DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
326 DOYLE ST W, TOCCOA, GA 30577-2314
(706) 886-7422
Mailing address
326 DOYLE ST W, TOCCOA, GA 30577-2314
(706) 886-7422
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
09035
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09035
PHARMACY LICENCE NUMBER
GA
Enumeration date
08/01/2006
Last updated
07/08/2007
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