Individual
ADDIE CAMPBELL-MUNGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9237 US HIGHWAY 19, BACONTON, GA 31716-7441
(448) 488-6758
Mailing address
9237 US HIGHWAY 19, BACONTON, GA 31716-7441
(448) 488-6758
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MSW012852
GA
Other
Enumeration date
03/19/2026
Last updated
03/19/2026
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