Individual
GENTRY BROACH TOLBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1000 HAWTHORNE AVE STE J, ATHENS, GA 30606-2168
(706) 286-8344
(706) 286-8346
Mailing address
1500 LANGFORD MEDICAL DRIVE, BLDG 200, BOGART, GA 30622
(706) 208-0451
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN175489
GA
Other
Enumeration date
06/30/2011
Last updated
07/03/2024
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