Individual
DORIS DEAN JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(770) 339-2345
(678) 990-3997
Mailing address
2825 NORTHEAST EXPY NE, APT. B3, ATLANTA, GA 30345-4206
(610) 850-4139
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN218680
GA
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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