Individual
GLORIA J. HARDIMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
245 RIVER FOREST DR, FAYETTEVILLE, GA 30214-3145
(770) 969-5081
Mailing address
245 RIVER FOREST DR, FAYETTEVILLE, GA 30214-3145
(770) 969-5081
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000
DEPARTMENT OF VA
—
Enumeration date
09/19/2019
Last updated
09/19/2019
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