Provider Information for 1326643974
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ALETA DEONNE O'QUINN
Sex: Female
NPI: 1326643974
Last Updated: 2020-12-02
Certification Date: 2020-12-02
Certification Date: 2020-12-02
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1326643974 | ||||||||
| Enumeration Date | 2020-12-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 507 COUNTRY FARM RD WAYCROSS, GA 31503-9400 United States Phone: 229-444-3434 | Fax: | ||||||||
| Primary Practice Address | 507 COUNTRY FARM RD WAYCROSS, GA 31503-9400 United States Phone: 229-444-3434 | Fax: | ||||||||
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