Individual
JOHN ROBERT INGENITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 WESTVIEW DR SW, ATLANTA, GA 30310-1458
(404) 756-1383
Mailing address
2918 OLLIE AVE, NORCROSS, GA 30071-2488
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/08/2024
Last updated
04/22/2024
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