Organization
MINDY JEWETT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GAYLE R ANDRUS (ORGANIZER)
(770) 638-3222
Entity
Organization
Contact information
Practice address
2060 LONGVIEW WAY, ATLANTA, GA 30341-1512
(678) 333-6311
Mailing address
2060 LONGVIEW WAY, ATLANTA, GA 30341-1512
(678) 333-6311
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
003045
GA
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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