Individual
AEREON CADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2529 WOLF DEN LN, ATLANTA, GA 30349-8767
(678) 357-0644
Mailing address
2529 WOLF DEN LN, ATLANTA, GA 30349-8767
(678) 357-0644
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
059340352
GA
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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