Individual
BEVERLY ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7173 COVINGTON HWY STE F2, LITHONIA, GA 30058-7616
(770) 696-5830
Mailing address
2945 ROSEBUD RD APT 406, LOGANVILLE, GA 30052-8951
(404) 483-3513
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO054294
GA
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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