Individual
CENOVIO FRAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
312 W MATILDA ST, DALTON, GA 30720-8837
(706) 581-8647
Mailing address
312 W MATILDA ST, DALTON, GA 30720-8837
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PHI-023008
GA
Other
Enumeration date
03/26/2026
Last updated
03/26/2026
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