Individual
JOSEPH ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 COLT RIDGE CIR SE, MABLETON, GA 30126-5707
(678) 754-0949
Mailing address
1500 COLT RIDGE CIR SE, MABLETON, GA 30126-5707
(678) 754-0949
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
04/18/2022
Last updated
04/18/2022
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