Individual
JENNIFER MOSS HOULE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7 DEPOT STREET, ELLIJAY, GA 30540
(706) 698-4002
(706) 698-4005
Mailing address
7 DEPOT STREET, ELLIJAY, GA 30540
(706) 698-4002
(706) 698-4005
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
MT001421
GA
Other
Enumeration date
06/19/2007
Last updated
08/27/2008
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