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1083351464
KENNETH DALE AUTRY
GRIFFIN, GA
NPI
1083351464
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: GA RN162470)
Enumeration Date
2022-05-17
Last Update Date
2022-05-17
Business Address
Mr. KENNETH DALE AUTRY FNP
726 S 8TH ST
GRIFFIN, GA 30224-4827
Phone number: 770-228-2273
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Mailing Address
Mr. KENNETH DALE AUTRY FNP
83 MOORE RD
GRIFFIN, GA 30223-5526
Phone number:
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