Individual
ALEXIS JACOBY POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3036 PALE MOON PL, MCDONOUGH, GA 30253-7496
(678) 643-0367
Mailing address
3036 PALE MOON PL, MCDONOUGH, GA 30253-7496
(678) 643-0367
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
44867
GA
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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