Individual
MAXINE DURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6206 PEMBROKE DR, REX, GA 30273-1246
(678) 755-3523
Mailing address
6206 PEMBROKE DR, REX, GA 30273-1246
(678) 755-3523
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
0
GA
253Z00000X
In Home Supportive Care Agency
NA
GA
253Z00000X
In Home Supportive Care Agency
Primary
PENDING
GA
253Z00000X
In Home Supportive Care Agency
—
GA
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
12/16/2022
Last updated
12/16/2022
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