Organization
KANISHA ALEXANDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANISHA MONIQUE ALEXANDER (STNA)
(614) 600-0807
Entity
Organization
Contact information
Practice address
1880 SHAMROCK DR, DECATUR, GA 30032-7011
(614) 600-0807
Mailing address
1880 SHAMROCK DR, DECATUR, GA 30032-7011
(614) 600-0807
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
501129910606
OH
Other
Enumeration date
12/22/2014
Last updated
12/22/2014
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