Individual
DEMETRIC ANTRON TUGGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3480 HEARTHSTONE PL, DOUGLASVILLE, GA 30135-7286
(470) 754-5144
Mailing address
3480 HEARTHSTONE PL, DOUGLASVILLE, GA 30135-7286
(470) 754-5144
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
040114469
GA
Other
Enumeration date
02/04/2022
Last updated
02/04/2022
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