Individual
KALIMBRIA JANTIA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1311 BROOKVALE DR, TIFTON, GA 31794-9424
(229) 402-8343
Mailing address
1311 BROOKVALE DR, TIFTON, GA 31794-9424
(229) 402-8343
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
11/10/2021
Last updated
11/10/2021
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