Individual
KEVIN PATRICK FEALY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 JUNIPER ST NE, ATLANTA, GA 30308-1307
(786) 521-2198
Mailing address
265 COBBLESTONE TRL, AVONDALE ESTATES, GA 30002-1225
(786) 521-2198
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
10/13/2023
Last updated
10/13/2023
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