OPAL MULLINGS BLAKE

LAWRENCEVILLE, GA
NPI1043629140
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: GA  RN 199200)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: GA  RN199200)
Enumeration Date2014-08-04
Last Update Date2016-01-04
Business Address
-- OPAL MULLINGS BLAKE NP-C
631 PROFESSIONAL DR STE 350
LAWRENCEVILLE, GA 30046-3370
Phone number: 770-995-0630
Mailing Address
-- OPAL MULLINGS BLAKE NP-C
631 PROFESSIONAL DR SUITE 350
LAWRENCEVILLE, GA 30046
Phone number: 770-995-0630