Individual
DOROTHY IGBONAGWAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2374
(678) 212-6350
Mailing address
2029 CARITHERS DR, MARIETTA, GA 30064-6014
(678) 698-8120
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN 222673
GA
Other
Enumeration date
02/05/2016
Last updated
02/05/2016
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