Individual
SOPHIA M MANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
156 RACCOON RUN, FORTSON, GA 31808-7326
(706) 596-0383
Mailing address
156 RACCOON RUN, FORTSON, GA 31808-7326
(706) 596-0383
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN055336
GA
Other
Enumeration date
02/02/2009
Last updated
02/02/2009
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