Individual
JESSE ALLEN NOWAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
153 INDEPENDENCE DR, CARROLLTON, GA 30116-9000
(770) 836-6678
Mailing address
44 LYNHAVEN DR, NEWNAN, GA 30263-1326
(404) 583-0310
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/01/2021
Last updated
06/01/2021
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