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Individual

AUTUMN WALTON MONGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1451 HIGHWAY 21 S STE H, SPRINGFIELD, GA 31329-5244
(912) 754-1035
(912) 754-1037
Mailing address
1451 HIGHWAY 21 S STE H, SPRINGFIELD, GA 31329-5244
(912) 754-1035
(912) 754-1037

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
09/02/2020
Last updated
11/06/2024
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