ATHENA JACOWAY

TUCKER, GA
NPI1376905117
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1744P3200X Specialist, Prosthetics Case Management
(Licence: GA  CO078139)
Enumeration Date2016-03-22
Last Update Date2016-03-22
Business Address
-- ATHENA JACOWAY
2258 NORTHLAKE PKWY 390
TUCKER, GA 30084-4019
Phone number: 678-754-3507
Mailing Address
-- ATHENA JACOWAY
1631 BRENTWOOD XING SE
CONYERS, GA 30013-6300
Phone number: 678-754-3507
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