Individual
ANDREA TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 WALKER ST, AMERICUS, GA 31709-3157
(229) 591-5178
Mailing address
205 WALKER ST, AMERICUS, GA 31709-3157
(229) 591-5178
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
020707065
GA
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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