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Individual

TONI BRENNETTE STANFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
600 MOUNTAINVIEW DR, COVINGTON, GA 30016-7191
(404) 287-8428
Mailing address
600 MOUNTAINVIEW DR, COVINGTON, GA 30016-7191
(404) 688-6731

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN000006542
GA

Other

Enumeration date
09/22/2020
Last updated
09/22/2020
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