Individual
ANGELA CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
108 WINDING WAY APT C, LEESBURG, GA 31763-2933
(229) 364-1511
Mailing address
108 WINDING WAY APT C, LEESBURG, GA 31763-2933
(229) 364-1511
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
055809498
GA
Other
Enumeration date
05/12/2017
Last updated
05/12/2017
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