Individual
MR. LARRY THOMAS DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1105 MADISON HIGHWAY, VALDOSTA, GA 31601
(229) 242-0253
(229) 259-9029
Mailing address
911 MADISON AVE, VALDOSTA, GA 31602
(229) 242-6271
(229) 259-9029
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHRE007971
GA
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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