Individual
POONAM DATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5675 JIMMY CARTER BLVD STE 665A, NORCROSS, GA 30071-2955
(770) 317-4533
Mailing address
510 BUTLER NATIONAL DR, JOHNS CREEK, GA 30097-5944
(770) 317-4533
(844) 461-5939
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/12/2018
Last updated
05/14/2021
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