Individual
MR. EARL R.. HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH.
Contact information
Practice address
220 W CENTRAL AVE, FITZGERALD, GA 31750-2438
(229) 423-0521
Mailing address
PO BOX 144, CHULA, GA 31733-0144
(229) 382-2779
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
009881
GA
Other
Enumeration date
05/04/2006
Last updated
09/22/2007
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