Organization
MOTHER S LOVE PWH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PERSAPHONE HARRIS NURSE PRACTITIONER (OWNER)
(470) 237-6708
Entity
Organization
Contact information
Practice address
4301 RESERVE DR NE, BROOKHAVEN, GA 30319-5919
(470) 237-6708
Mailing address
4301 RESERVE DR NE, BROOKHAVEN, GA 30319-5919
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
—
—
Other
Enumeration date
06/14/2021
Last updated
08/04/2021
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