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1235705203
JESSE ALLEN NOWAK
CARROLLTON, GA
NPI
1235705203
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2021-06-01
Last Update Date
2021-06-01
Business Address
JESSE ALLEN NOWAK
153 INDEPENDENCE DR
CARROLLTON, GA 30116-9000
Phone number: 770-836-6678
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Mailing Address
JESSE ALLEN NOWAK
44 LYNHAVEN DR
NEWNAN, GA 30263-1326
Phone number: 404-583-0310
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