Individual
JARED REICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
65 SUNRISE DR, GRANTVILLE, GA 30220-2854
(770) 312-5137
Mailing address
643 MAIN ST, PALMETTO, GA 30268-1138
(404) 929-8824
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN225678
GA
Other
Enumeration date
06/02/2017
Last updated
09/21/2021
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