Individual
GISELE WOGBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
750 TOWNPARK LN NW, KENNESAW, GA 30144-5579
(404) 365-0966
Mailing address
750 TOWNPARK LN NW, KENNESAW, GA 30144-5579
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
104254
GA
Other
Enumeration date
04/20/2022
Last updated
09/16/2025
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