Individual
AMBREEN MARDHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 PROMINENCE POINT PKWY, SUITE 104, CANTON, GA 30114-1236
(770) 704-6988
Mailing address
104 PROMINENCE POINT PKWY, SUITE 104, CANTON, GA 30114-1236
(770) 704-6988
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
075722
GA
Other
Enumeration date
05/24/2013
Last updated
08/24/2016
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