Individual
RICKY J ROWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
104 N MADISON ST, QUITMAN, GA 31643-2012
(229) 263-8851
Mailing address
PO BOX 288, QUITMAN, GA 31643-0288
(229) 263-8851
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1026
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00274293A
—
GA
Enumeration date
03/14/2007
Last updated
07/08/2007
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