Individual
KRISTAL CURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4057 MADIOSN COURT, ELLENWOOD, GA 30294
(678) 684-8420
Mailing address
4057 MADIOSN COURT, ELLENWOOD, GA 30294
(678) 684-8420
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN075798
GA
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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