Individual
CHANELLE KIMBROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2955 COBB PKWY SE STE 301, ATLANTA, GA 30339-3523
(334) 603-8361
Mailing address
3145 LANDINGTON DR, AUSTELL, GA 30106-3536
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO121548
GA
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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