Individual
BONNIE GRAY-MAULDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1408 HARBOR LNDG, ROSWELL, GA 30076-3123
(678) 542-4053
(678) 802-2899
Mailing address
1408 HARBOR LNDG, ROSWELL, GA 30076-3123
(678) 542-4053
(678) 802-2899
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
308085749
GA
332BX2000X
Oxygen Equipment & Supplies (DME)
308085749
GA
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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