Individual
MARISSA ASHLEY HATEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
296 ORANGE ST APT 5, MACON, GA 31201-1688
(478) 595-9529
Mailing address
296 ORANGE ST APT 5, MACON, GA 31201-1688
(478) 595-9529
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003236
GA
Other
Enumeration date
07/01/2019
Last updated
07/01/2019
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