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Individual

MS. VANESSA KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CST, CPC-A

Contact information

Practice address
145 FOREST HALL LN, FAYETTEVILLE, GA 30214-4025
(770) 987-9228
(770) 629-2380
Mailing address
PO BOX 142765, FAYETTEVILLE, GA 30214-6520
(770) 987-9228
(770) 629-2380

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
03/27/2012
Last updated
03/27/2012
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