Individual
MR. JOHN BENJAMIN ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
1 MEADOWS PKWY, VIDALIA, GA 30474-8759
(912) 403-0518
Mailing address
PO BOX 1541, VIDALIA, GA 30475-1541
(912) 403-0518
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
127500
GA
Other
Enumeration date
12/27/2011
Last updated
12/27/2011
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