Individual
MRS. KASSONA WOODS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3406 CENTERVILLE LN, SNELLVILLE, GA 30039-4605
(404) 273-5332
Mailing address
3406 CENTERVILLE LN, SNELLVILLE, GA 30039-4605
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PTA002048
GA
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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