Individual
KIYATHA GENERAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
455 FREEMAN DR, COVINGTON, GA 30016-8958
(404) 781-3559
Mailing address
455 FREEMAN DR, COVINGTON, GA 30016-8958
(404) 781-3559
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0028904717
GA
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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