Individual
EBONY EVERETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
119 TODD RD, PERRY, GA 31069-9312
(478) 952-7441
Mailing address
PO BOX 457, PERRY, GA 31069-0457
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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