Individual
KIMBERLY DEANN SLAUGHTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2313 KATY CT, ALBANY, GA 31707-6696
(229) 449-5146
Mailing address
2313 KATY CT, ALBANY, GA 31707-6696
(229) 449-5146
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
050982278
GA
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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