Individual
MR. ERIC LAROY DONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
716 WESTOVER AVE, THOMASVILLE, GA 31792-6333
(229) 403-2456
Mailing address
716 WESTOVER AVE, THOMASVILLE, GA 31792-6333
(229) 403-2456
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
691097196
FL
172V00000X
Community Health Worker
691097198
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
691097196
—
FL
05
—
691097198
—
FL
Enumeration date
06/03/2010
Last updated
06/03/2010
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