Individual
ICEESHO BETHEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RRT
Contact information
Practice address
2086 JODECO RD # 1674, MCDONOUGH, GA 30253-5220
(678) 763-9797
Mailing address
2086 JODECO RD # 1674, MCDONOUGH, GA 30253-5220
(678) 763-9797
Taxonomy
Speciality
Code
Description
License number
State
2278G0305X
Geriatric Care Certified Respiratory Therapist
Primary
7058
GA
2278H0200X
Home Health Certified Respiratory Therapist
7058
GA
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
7058
GA
Other
Enumeration date
09/18/2012
Last updated
03/23/2026
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