Individual
QUANETTA MAE FARMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1745 WELLS RD APT 103, ORANGE PARK, FL 32073-6717
(904) 450-3624
Mailing address
1745 WELLS RD APT 103, ORANGE PARK, FL 32073-6717
(904) 450-3624
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
FL
Other
Enumeration date
07/04/2022
Last updated
08/03/2022
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