Organization
DROW-OPTIMUM MULTISPECIALTY
Active
Organization
DROW-OPTIMUM MULTISPECIALTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONI D DONNELL (CREDENTIAL MANAGER)
(832) 993-8374
Entity
Organization
Contact information
Practice address
3009 RAINBOW DR STE 139D, DECATUR, GA 30034-1640
(770) 743-6585
Mailing address
3009 RAINBOW DR STE 139D, DECATUR, GA 30034-1640
(770) 743-6585
Taxonomy
Speciality
Code
Description
License number
State
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
—
GA
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
05/14/2017
Last updated
07/21/2022
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