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Individual

MRS. BENEDETH UJU MOH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9411 S MAIN ST STE D, JONESBORO, GA 30236-8705
(770) 477-4755
(770) 477-4758
Mailing address
9411 S MAIN ST STE D, JONESBORO, GA 30236-8705
(770) 477-4755
(770) 477-4758

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
031 R 0040
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
457729570D
GA
Enumeration date
07/17/2006
Last updated
09/16/2008
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