Individual
SUSAN MARINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
232 HIAWASSEE DR, WOODSTOCK, GA 30188-7851
(770) 687-4207
Mailing address
232 HIAWASSEE DR, WOODSTOCK, GA 30188-7851
(770) 687-4207
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT008734
GA
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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