Individual
MARY HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(770) 836-9684
Mailing address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(770) 836-9684
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN205025
GA
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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