Individual
MR. GREGORY YOUNG SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1710 LAMAR AVE, WAYCROSS, GA 31503-5852
(912) 816-5867
Mailing address
1710 LAMAR AVE, WAYCROSS, GA 31503-5852
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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