Individual
MARTHA SANDRA AMAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
108 OOTHCALOOGA ST, CALHOUN, GA 30701-2332
(706) 844-2172
Mailing address
620 JOHNSON LAKE RD SE, ADAIRSVILLE, GA 30103-3707
(706) 844-2172
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT009079
GA
Other
Enumeration date
09/02/2013
Last updated
09/02/2013
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