| Doctor Name: | JERRY LABRON RAGON |
| NPI Number: | 1053638874 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 6357 |
| Business Practice Address: | 8 W 8th St Chickamauga, GA - 307071308 |
| Business Phone Number: | 4238029804 |
| Business Fax Number: | 8772596370 |
| Mailing Address: | 8 W 8th St, CHICKAMAUGA |
| State: | GA |
| Postal Code: | 307071308 |
| Phone Number: | 4238029804 |
| Fax Number: | 8772596370 |
| NPI Enumeration Date: | 05/04/2010 |
| NPI Last Update Date: | 05/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171WH0202X |
| License Number: | 6357 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Contractor |
| Taxonomy Specialization: | Home Modifications |
| Taxonomy Definition: | |