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Organization

MOTHER S LOVE PWH PLLC

Active
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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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