Individual
CONSUELA KATRICE WOODSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 N 1ST ST, CORDELE, GA 31015-3688
22994733016
Mailing address
1003 N 1ST ST, CORDELE, GA 31015-3688
22994733016
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/12/2017
Last updated
03/17/2018
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