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Individual

MRS. SUSAN CAPITAN SEXTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NCTMB

Contact information

Practice address
574 CHURCH ST NE, MARIETTA, GA 30060-1358
(770) 519-7778
Mailing address
1766 APPLE BLVD, MARIETTA, GA 30066-2955
(770) 579-5868

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4587
GA

Other

Enumeration date
03/18/2008
Last updated
03/18/2008
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