Individual
AMANDA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6003 PRODIGY LN, LOCUST GROVE, GA 30248-3652
(470) 234-3138
Mailing address
6003 PRODIGY LN, LOCUST GROVE, GA 30248-3652
(470) 234-3138
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
03/08/2024
Last updated
03/08/2024
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