Individual
ARETHA MIZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
925 KAMERA RD, DOUGLAS, GA 31535-4345
(912) 381-8313
Mailing address
925 KAMERA RD, DOUGLAS, GA 31535-4345
(912) 381-8313
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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