Individual
JAKELL THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DIRECTOR
Contact information
Practice address
103 KARIS CT, PERRY, GA 31069-4878
(229) 460-0006
Mailing address
103 KARIS CT, PERRY, GA 31069-4878
(229) 460-0006
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
Q6H5B5D5
GA
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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