Individual
MS. MARY CELESTE WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RT
Contact information
Practice address
1029 TRAVELERS TRL NW, KENNESAW, GA 30144-2870
(770) 428-1026
Mailing address
1029 TRAVELERS TRL NW, KENNESAW, GA 30144-2870
(770) 428-1026
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
0120005300
VA
Other
Enumeration date
03/12/2008
Last updated
03/12/2008
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