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Individual

TAIDRA DENEAN TIMES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
205 E 6TH AVE, BUENA VISTA, GA 31803-1909
(229) 331-9033
Mailing address
PO BOX 98, BUENA VISTA, GA 31803-0098
(229) 331-9033

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
GA

Other

Enumeration date
08/11/2021
Last updated
08/11/2021
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