Individual
EMMAUNDIA ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 CLAYTON ST, FAIRBURN, GA 30213-1518
(404) 200-3072
Mailing address
120 CLAYTON ST, FAIRBURN, GA 30213-1518
(404) 200-3072
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
GA
Other
Enumeration date
09/27/2023
Last updated
09/27/2023
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