Individual
MS. TERESA DIANNE PONDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
59 HOSPITAL RD, NEWNAN, GA 30263-1209
(678) 854-6394
Mailing address
90 MILLARD FARMER IND BLVD # 222, NEWNAN, GA 30263-1077
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN140110
GA
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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