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Individual

MRS. MARY AZUH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1069 LAKEFIELD WALK, MARIETTA, GA 30064-5758
(770) 356-7597
(770) 726-7108
Mailing address
1069 LAKEFIELD WALK, MARIETTA, GA 30064-5758
(770) 356-7597
(770) 726-7108

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
003159422A
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003159422A
GA
Enumeration date
11/12/2015
Last updated
11/12/2015
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