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Individual

CAMONIE MASON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7140 BEDROCK CIR, LITHONIA, GA 30038-3372
(804) 895-3258
Mailing address
7140 BEDROCK CIR, LITHONIA, GA 30038-3372
(804) 895-3258

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000
DEPARTMENT OF VA
Enumeration date
10/02/2019
Last updated
10/02/2019
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