Individual
OLUCHI IDENYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 S 8TH ST, GRIFFIN, GA 30224-4213
(470) 953-4803
Mailing address
601 S 8TH ST, GRIFFIN, GA 30224-4213
(470) 935-4803
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
01/14/2024
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