Individual
MARQUAIL DEVON NESMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
114 FOSTER CIR # 114, FAIRBURN, GA 30213-1261
(770) 892-7555
Mailing address
114 FOSTER CIR, FAIRBURN, GA 30213-1261
(770) 892-7555
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
053312786
GA
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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