Individual
MARTHA COLVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
235 E PONCE DE LEON AVE STE 225, DECATUR, GA 30030-3488
(404) 974-2550
(877) 619-6722
Mailing address
235 E PONCE DE LEON AVE STE 225, DECATUR, GA 30030-3488
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
86671
GA
Other
Enumeration date
07/05/2011
Last updated
07/05/2011
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