Individual
BEVIN CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3405 SWEETWATER RD APT 224, LAWRENCEVILLE, GA 30044-2449
(404) 514-5511
Mailing address
3405 SWEETWATER RD APT 224, LAWRENCEVILLE, GA 30044-2449
(404) 514-5511
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/21/2016
Last updated
02/21/2016
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