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1306003991
MARK KIM DE MEZA
DECATUR, GA
NPI
1306003991
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
(Licence: GA 000050)
Enumeration Date
2008-05-21
Last Update Date
2008-05-21
Business Address
-- MARK KIM DE MEZA CPO
1670 CLAIRMONT RD
DECATUR, GA 30033-4004
Phone number: 404-321-6111
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Mailing Address
-- MARK KIM DE MEZA CPO
11835 HIGHLAND COLONY DR
ROSWELL, GA 30075-2169
Phone number: 404-277-5197
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