Provider Information for 1568988269
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Mr. DAMION FARROW
Sex: Male
NPI: 1568988269
Last Updated: 2017-08-15
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1568988269 | ||||||||
| Enumeration Date | 2017-08-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 5716 CAVE SPRINGS RD DOUGLASVILLE, GA 30134-3617 United States Phone: 678-599-0011 | Fax: | ||||||||
| Primary Practice Address | 523 DIXIE ST CARROLLTON, GA 30117-3870 United States Phone: 770-812-8863 | Fax: | ||||||||
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