Individual
CODY LONGFELLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
183 WHITEFOORD AVE NE, ATLANTA, GA 30307-2803
(330) 256-8081
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/13/2019
Last updated
02/13/2019
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