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1114563046
TERRY MACK
LAWRENCEVILLE, GA
NPI
1114563046
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: FL 9478449)
Enumeration Date
2019-11-26
Last Update Date
2019-11-26
Business Address
TERRY MACK
175 GWINNETT DR
LAWRENCEVILLE, GA 30046-8444
Phone number: 678-209-2394
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Mailing Address
TERRY MACK
2303 TREE SUMMIT PKWY
DULUTH, GA 30096-7926
Phone number:
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