Organization
VITALMED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIA DENAE KING (NURSE PRACTITIONER)
(561) 449-1129
Entity
Organization
Contact information
Practice address
3502 MCCALLISTER LN, CONYERS, GA 30013-7500
(561) 449-1129
Mailing address
3502 MCCALLISTER LN, CONYERS, GA 30013-7500
(561) 449-1129
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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