Individual
TAKAI SADE HOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AHA INSTRUCTOR
Contact information
Practice address
1330 US HIGHWAY 319N LOT 38, NORMAN PARK, GA 31771-6121
(229) 454-5476
Mailing address
1330 US HIGHWAY 319N LOT 38, NORMAN PARK, GA 31771-6121
(229) 454-5476
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
06200872758
GA
Other
Enumeration date
04/26/2021
Last updated
04/26/2021
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