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Individual

TRICIA MARIE MIZELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.T. (R) (ARRT)

Contact information

Practice address
1504 HARDEMAN AVE, SUITE B, MACON, GA 31201-1441
(478) 745-3135
(478) 745-3136
Mailing address
1504 HARDEMAN AVE, SUITE B, MACON, GA 31201-1441
(478) 745-3135
(478) 745-3136

Taxonomy

Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
496508
GA

Other

Enumeration date
01/14/2013
Last updated
01/14/2013
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