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Individual

MR. ANTHONY IZORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
5163 TALL OAK DRIVE, MARIETTA, GA 30068
(407) 733-2289
Mailing address
5163 TALL OAK DRIVE, MARIETTA, GA 30068
(407) 733-2289

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN189830
GA

Other

Enumeration date
04/18/2017
Last updated
04/18/2017
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