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Individual

TESSA REE MINGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4912 BILL GARDNER PARKWAY, LOCUST GROVE, GA 30248-3025
(662) 542-4644
Mailing address
2030 TOWNE PARK DR, MCDONOUGH, GA 30252
(662) 542-4464

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
C0138190
GA

Other

Enumeration date
10/28/2021
Last updated
10/28/2021
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