Individual
KWIZERA RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4749 BANNER ELK DR, STONE MOUNTAIN, GA 30083-4916
(404) 944-6826
Mailing address
4749 BANNER ELK DR, STONE MOUNTAIN, GA 30083-4916
(404) 944-6826
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN313569
GA
163WH0200X
Home Health Registered Nurse
RN313569
GA
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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