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Organization

ANNTIONEEK BOSTON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ANNTIONEEK MARSHELLE BOSTON CERTIFIED (HAIR LOSS SPECIALIST)
(678) 744-3440
Entity
Organization

Contact information

Practice address
870 CRESTMARK DR, SUITE 200, LITHIA SPRINGS, GA 30122-2665
(678) 744-3440
Mailing address
PO BOX 733, PALMETTO, GA 30268-0733
(678) 744-3440

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1744P3200X
MEDICAL INSURANCE COMPANIES
GA
Enumeration date
02/21/2017
Last updated
02/21/2017
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