Individual
DEEDGRA ALBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPT
Contact information
Practice address
4013 CREEK STATION LN, STONE MOUNTAIN, GA 30083-7004
(404) 246-9098
Mailing address
PO BOX 361134, DECATUR, GA 30036-1134
(404) 246-9098
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
48107
GA
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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