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Individual

ELIZABETH P SUMO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
EA

Contact information

Practice address
1561 VIRGINIA AVE STE 208A, COLLEGE PARK, GA 30337-2897
(770) 702-0746
(866) 920-4718
Mailing address
1561 VIRGINIA AVE STE 208A, COLLEGE PARK, GA 30337-2897
(770) 702-0746
(866) 920-4718

Taxonomy

Speciality
Code
Description
License number
State
374700000X
Technician
Primary
3014901
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17659543
NPN
GA
Enumeration date
01/20/2023
Last updated
01/20/2023
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