Individual
SANDETTE MILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1493 SHANNA DR, TIFTON, GA 31794-9504
(229) 848-4129
(229) 386-8523
Mailing address
1493 SHANNA DR, TIFTON, GA 31794-9504
(229) 848-4129
(229) 386-8523
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
051259702
GA
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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