Individual
MANDEEP K MATHAUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
400 DAWSON COMMONS CIR STE 410, DAWSONVILLE, GA 30534-6269
(706) 344-1263
Mailing address
5911 IVY SUMMIT CT, CUMMING, GA 30041-7136
(330) 999-9315
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
097648
GA
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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