Individual
MR. JERRY ALLEN COPELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
437 W PARKER ST, BAXLEY, GA 31513-0605
(912) 705-0858
(912) 705-6423
Mailing address
437 W PARKER ST, BAXLEY, GA 31513-0605
(912) 705-0858
(912) 705-6423
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP1600X
Pastoral Counselor
Primary
—
GA
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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