MR. Jett Lavern Mccullough, PHARMACIST

NPI #1790992154 in Thomson, Georgia

Provider Information

NPI Number: 1790992154
Entity Type: Individual
Name: MR. Jett Lavern Mccullough, PHARMACIST
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: PHARMACIST
Enumeration Date: May 16, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 433 W HILL ST
City: Thomson
State: Georgia
ZIP Code: 30824-2116
Phone: (706) 595-4842

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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