Individual
KWASI K. AMPOMAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
455 PHILIP BLVD STE 140, LAWRENCEVILLE, GA 30046-8768
(770) 962-3642
(770) 962-3643
Mailing address
455 PHILIP BLVD STE 140, LAWRENCEVILLE, GA 30046-8768
(770) 962-3642
(770) 962-3643
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
0102206854
VA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
102584
GA
Other
Enumeration date
04/29/2019
Last updated
01/24/2025
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