Individual
MELISSA GARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
339 SPRINGHAVEN RD, DEXTER, GA 31019-3406
(478) 875-1425
Mailing address
339 SPRINGHAVEN RD, DEXTER, GA 31019-3406
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APPLIED FOR
—
GA
Enumeration date
04/18/2007
Last updated
07/09/2007
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