Individual
MARK J AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
710 N 5TH AVE NE, ROME, GA 30165-2704
(706) 291-0999
(706) 291-2558
Mailing address
710 N 5TH AVE NE, ROME, GA 30165-2704
(706) 291-0999
(706) 291-2558
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
013593
GA
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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