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Individual

ANGELIQUE CROWDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
375 HIGHLAND AVE NE, ATLANTA, GA 30312-1375
(404) 797-9778
Mailing address
780 MOROSGO DR NE UNIT 13571, ATLANTA, GA 30324-0571
(404) 797-9778

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CO111160
GA

Other

Enumeration date
05/17/2018
Last updated
05/17/2018
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