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1396271292
JELISA CARROLL
BRUNSWICK, GA
NPI
1396271292
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Former Name
JELISA ANITA REED
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: GA 86289)
Enumeration Date
2017-05-11
Last Update Date
2024-07-12
Business Address
JELISA CARROLL
2916 GLYNN AVE
BRUNSWICK, GA 31520-4844
Phone number: 912-466-5850
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Mailing Address
JELISA CARROLL
2916 GLYNN AVE
BRUNSWICK, GA 31520-4844
Phone number: 921-466-5850
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