Individual
CHAKITA MIESHA ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFA
Contact information
Practice address
24 HALYARD DR, PORT WENTWORTH, GA 31407-9755
(912) 507-0413
Mailing address
24 HALYARD DR, PORT WENTWORTH, GA 31407-9755
(912) 507-0413
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
189859
GA
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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