JACK EDWARD FUNDERBURK

MOULTRIE, GA
NPI1346530847
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: GA  RPH010666)
Enumeration Date2011-04-18
Last Update Date2011-04-18
Business Address
Mr. JACK EDWARD FUNDERBURK
305 6TH ST SE
MOULTRIE, GA 31768-4842
Phone number: 229-984-1378
Mailing Address
Mr. JACK EDWARD FUNDERBURK
305 6TH ST SE
MOULTRIE, GA 31768-4842
Phone number: 229-984-1378