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1275111304
BOLIVIA TRACI JENKINS
GRAY, GA
NPI
1275111304
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: GA 99763)
Enumeration Date
2021-03-30
Last Update Date
2024-08-15
Business Address
BOLIVIA TRACI JENKINS MD
1005 BOULDER DR
GRAY, GA 31032-6141
Phone number: 478-621-2072
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Mailing Address
BOLIVIA TRACI JENKINS MD
1005 BOULDER DR
GRAY, GA 31032-6141
Phone number: 478-621-2072
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