Individual
MR. TAUFIIQ KHADRIS COLBERT SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
255 KORY DR, NEWNAN, GA 30263-7045
(267) 228-8083
Mailing address
255 KORY DR, NEWNAN, GA 30263-7045
(267) 228-8083
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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