Individual
RODNEESHA THORNTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 LANIER AVE W STE 403, FAYETTEVILLE, GA 30214-7638
(916) 821-5392
Mailing address
1209 HUNTER CV, JONESBORO, GA 30238-7813
(916) 821-5392
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO121848
GA
Other
Enumeration date
01/26/2015
Last updated
01/28/2015
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