Individual
MRS. PHYLLIS MARY MANN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2121A BELLEVUE RD, DUBLIN, GA 31021-2998
(478) 272-1190
(478) 272-6509
Mailing address
2851 ROZAR GOOLSBY RD, EASTMAN, GA 31023-2225
(478) 374-2743
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN018687
GA
Other
Enumeration date
12/13/2005
Last updated
07/08/2007
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