Individual
JUANITA WHITEHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
835 JOHNSON RD APT 16, WARNER ROBINS, GA 31093-7221
(478) 952-5010
Mailing address
835 JOHNSON RD APT 16, WARNER ROBINS, GA 31093-7221
(478) 952-5010
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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