RALLIE D COGBURN

MACON, GA
NPI1548265549
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: GA  003476)
Enumeration Date2005-06-16
Last Update Date2014-10-03
Business Address
Mr. RALLIE D COGBURN PA
6070 LAKESIDE COMMONS DR
MACON, GA 31210-5778
Phone number: 478-254-2644
Mailing Address
Mr. RALLIE D COGBURN PA
PO BOX 26790
MACON, GA 31221-6790
Phone number: 478-254-2644
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