Individual
JUSTIN TYLER DUMRONGKULRAKSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 REDMOND RD NW, ROME, GA 30165-1415
(706) 802-3063
Mailing address
501 REDMOND RD NW, ROME, GA 30165-1415
(706) 802-3063
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/31/2021
Last updated
07/19/2021
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