Individual
TERRY LYNN MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 MOUNT ZION RD STE 15, MORROW, GA 30260-2241
(470) 651-0674
Mailing address
1105 KNIGHT CHASE DR, STOCKBRIDGE, GA 30281-2074
(470) 651-0674
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
BL0017822019
GA
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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