Individual
MR. JORGE CARABALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5672 HARBORMIST DR, POWDER SPRINGS, GA 30127-6963
(678) 997-4048
Mailing address
PO BOX 867, POWDER SPRINGS, GA 30127-6963
(678) 997-4048
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
OCC014925
GA
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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