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Individual

MELISSA JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
136 ROSA LN, QUITMAN, GA 31643-3680
(229) 561-2099
Mailing address
136 ROSA LANE, QUITMAN, GA 31643
(229) 561-2099

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
586
GA

Other

Enumeration date
09/29/2016
Last updated
09/29/2016
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