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1134979263
JERRELL FANG
GAINESVILLE, GA
NPI
1134979263
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-22
Last Update Date
2024-03-22
Business Address
JERRELL FANG
743 SPRING ST NE
GAINESVILLE, GA 30501-3715
Phone number: 770-219-9000
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Mailing Address
JERRELL FANG
743 SPRING ST NE STE 710
GAINESVILLE, GA 30501-3715
Phone number: 770-219-8730
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