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Individual

MEDINA KING--HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
101 WYOMING ST, ADEL, GA 31620-5214
(229) 630-2241
Mailing address
PO BOX 341, ADEL, GA 31620-0341
(229) 630-2241

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
09/21/2016
Last updated
09/21/2016
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