RICKY O TATUM

WAYCROSS, GA
NPI1073837555
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: GA  002235)
Enumeration Date2010-03-26
Last Update Date2010-03-26
Business Address
RICKY O TATUM PAC
1007 MARY ST
WAYCROSS, GA 31503-3823
Phone number: 912-449-8601
Mailing Address
RICKY O TATUM PAC
1007 MARY ST
WAYCROSS, GA 31503-3823
Phone number: 912-449-8601
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