Individual
AIWANE IBOAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
1900 10TH AVE, SUITE # 100, COLUMBUS, GA 31901-3600
(706) 571-1430
(706) 571-1604
Mailing address
2020 PEACHTREE RD NW, ATLANTA, GA 30309-1426
(404) 352-2020
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
82949
GA
Other
Enumeration date
04/23/2014
Last updated
08/08/2019
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