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Individual

PHILIP WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4331 THURMOND TANNER PRKY, FLOWERY BRANCH, GA 30542-2829
(678) 513-5700
(678) 513-5836
Mailing address
228 NORTH COLLEGE AVE, HARTWELL, GA 30643
(706) 376-4002
(706) 376-9020

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC006839
GA

Other

Enumeration date
07/03/2012
Last updated
07/03/2012
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