Individual
NEKITA BURRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 CEDARMONT WAY, DALLAS, GA 30132-0550
(404) 889-9288
Mailing address
118 CEDARMONT WAY, DALLAS, GA 30132-0550
(404) 889-9288
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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