Individual
THERESA MARIE WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1105 BURLEYSON RD, DALTON, GA 30720-3181
(706) 278-4640
(706) 275-6599
Mailing address
1105 BURLEYSON RD, DALTON, GA 30720-3181
(706) 278-4640
(706) 275-6599
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
92790
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2018
Last updated
08/01/2022
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