Individual
CORETTA KING-BRASWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2822 WOODHOLLOW LN, JONESBORO, GA 30236-2829
(386) 338-8222
Mailing address
PO BOX 1194, JONESBORO, GA 30237-1194
(386) 338-8222
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
81-1453757
GA
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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