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Individual

IFEYINWA DORIS OTIJI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
1206 YELLOW RIVER DR, LAWRENCEVILLE, GA 30043-8499
(301) 237-6976

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN091988
GA

Other

Enumeration date
08/21/2019
Last updated
08/21/2019
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