Organization
CLINICA AGAVE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH T CHABOT FNP-C (PROVIDER)
(404) 447-3444
Entity
Organization
Contact information
Practice address
4434 JONESBORO RD, FOREST PARK, GA 30297-4313
(404) 447-3444
(404) 377-3445
Mailing address
4434 JONESBORO RD, FOREST PARK, GA 30297-4313
(404) 447-3444
(404) 377-3445
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/16/2008
Last updated
12/16/2008
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