Individual
ROSHANDA PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1309 GREENVIEW DR, GRIFFIN, GA 30224-4048
(678) 603-1484
Mailing address
1309 GREEN VIEW DRIVE, GRIFFIN, GA 30224-7452
(678) 603-1484
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
465422576
GA
Other
Enumeration date
04/18/2014
Last updated
04/18/2014
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