Individual
JONATHAN CADE MCCULLAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
980 W PARKER ST, BAXLEY, GA 31513-0653
(912) 367-3234
Mailing address
109 ROGERS ST, HAZLEHURST, GA 31539-6601
(912) 347-7053
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH031632
GA
Other
Enumeration date
03/16/2021
Last updated
03/16/2021
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