Individual
QURA WOODBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
464 VININGS VINTAGE CIR, MABLETON, GA 30126-7207
(770) 853-3216
Mailing address
464 VININGS VINTAGE CIR, MABLETON, GA 30126-7207
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
03/07/2014
Last updated
03/07/2014
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