Individual
PHILLIP JENNINGS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
(678) 212-6343
Mailing address
208 BERKELEY WOODS DR, DULUTH, GA 30096-6346
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN101949
GA
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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