Individual
OLUWAFUNMILAYO MAKINDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4140 MOORE RD STE B114, SUWANEE, GA 30024-7157
(678) 866-1468
Mailing address
1268 AUSTIN THOMAS DR, DACULA, GA 30019-1681
(818) 795-6255
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
460548974
MED SPA
GA
Enumeration date
08/18/2022
Last updated
08/18/2022
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