Individual
FONTONYA MYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CERT HAIR LOSS SPEC
Contact information
Practice address
330 ARROWHEAD BLVD, APT. 18A, JONESBORO, GA 30236-1105
(470) 216-8183
Mailing address
330 ARROWHEAD BLVD, APT. 18A, JONESBORO, GA 30236-1105
(470) 216-8183
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
02/26/2015
Last updated
02/26/2015
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