Individual
JENNIFER VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1969 BRIARCLIFF WAY, SUGAR HILL, GA 30518-2981
(781) 469-6919
Mailing address
2710 WYNDHAM PLACE DR, LAWRENCEVILLE, GA 30044-3682
(770) 773-0141
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
RBT-21-175507
GA
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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