Individual
EDITH EZEIGBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W LANIER AVE, BUILDING 200, SUITE 202, FAYETTEVILLE, GA 30214-7636
(770) 471-3487
Mailing address
1908 RIVER WAY, JONESBORO, GA 30236-7436
(770) 471-3487
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/03/2009
Last updated
03/03/2009
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