Individual
YAH OLSTHOORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2602 ASHLEY CLUB CIR, NORCROSS, GA 30092-4322
(908) 422-9310
Mailing address
2602 ASHLEY CLUB CIR, NORCROSS, GA 30092-4322
(908) 422-9310
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
2011019759
GA
Other
Enumeration date
09/19/2011
Last updated
09/19/2011
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