Kenneth Fanning

NPI #1982273827 in Saint Marys, Georgia

Provider Information

NPI Number
1982273827
Entity Type
Individual
Name
Kenneth Fanning
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Pharmacist
Enumeration Date
Jun 24, 2021
Last Updated
Jul 27, 2021

Practice Location

Address
555 CHARLIE SMITH SR HWY
State
Georgia
ZIP Code
31558-3030
Phone
(904) 616-9096

Specialties & Taxonomy Codes

Specialty
Pharmacist

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