Individual
BEANITA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4836 VENTNORE PL, DOUGLASVILLE, GA 30135-9001
(678) 282-7255
Mailing address
4836 VENTNORE PL, DOUGLASVILLE, GA 30135-9001
(678) 282-7255
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/10/2021
Last updated
05/10/2021
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