Individual
TIFFANY COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPSGT
Contact information
Practice address
148 BILL CARRUTH PKWY STE 290, HIRAM, GA 30141-3764
(470) 644-1709
Mailing address
148 BILL CARRUTH PKWY STE 290, HIRAM, GA 30141-3764
(470) 644-1709
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
11000
GA
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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