Individual
EGHEOSA BAZUAYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1625 CONLEY RD APT 149, CONLEY, GA 30288-1869
(770) 789-3833
Mailing address
1625 CONLEY RD APT 149, CONLEY, GA 30288-1869
(770) 789-3833
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/14/2019
Last updated
02/14/2019
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