Individual
MISS MAXINE HINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2363 CLIFTON SPRINGS RD, DECATUR, GA 30034-2911
(404) 918-7016
Mailing address
619 WASHINGTON DR, JONESBORO, GA 30238-8520
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
287680
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22082197
—
GA
Enumeration date
04/28/2022
Last updated
04/28/2022
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