Individual
DAVIDETTA FREEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SFA, CST
Contact information
Practice address
1473 ALAMEIN DR, LAWRENCEVILLE, GA 30046-2862
(678) 425-4568
(678) 403-0334
Mailing address
1473 ALAMEIN DR, LAWRENCEVILLE, GA 30046-2862
(678) 425-4344
(678) 403-0334
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
155777
GA
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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