Individual
T. MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1675 ROSWELL RD, #1616, MARIETTA, GA 30062-3662
(770) 771-2597
Mailing address
1675 ROSWELL RD, #1616, MARIETTA, GA 30062-3662
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN085333
GA
Other
Enumeration date
04/09/2013
Last updated
07/30/2014
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