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Individual

MISS SHIRLEY ANN MORTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
188 NORTH AVE, JONESBORO, GA 30236-3215
(678) 519-4798
Mailing address
8946 BENTWOOD LN, RIVERDALE, GA 30274-4511
(678) 519-4798

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
GA

Other

Enumeration date
11/03/2016
Last updated
01/21/2017
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