Individual
MRS. MONIQUE CHANTEL BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
203 W GENERAL SCREVEN WAY APT B, HINESVILLE, GA 31313-3034
(253) 592-8442
Mailing address
81 GREENBRIAR ST NE, LUDOWICI, GA 31316-6276
(253) 592-8442
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
CO127672
GA
Other
Enumeration date
07/05/2018
Last updated
07/05/2018
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