Individual
SHIRLEY O GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1703 PINEWALK LN, RIVERDALE, GA 30296-2561
(404) 988-4434
(470) 878-0056
Mailing address
1703 PINEWALK LN, RIVERDALE, GA 30296-2561
(404) 988-4434
(470) 878-0056
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
031-R-1766
GA
Other
Enumeration date
08/14/2019
Last updated
08/14/2019
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