LEONIA JACKSON VINCENT

MACON, GA
NPI1427818624
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: GA  16004)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-03-22
Last Update Date2024-05-30
Business Address
LEONIA JACKSON VINCENT
777 HEMLOCK STREET LN # 165
MACON, GA 31201-2168
Phone number: 478-633-1634
Mailing Address
LEONIA JACKSON VINCENT
777 HEMLOCK STREET LN # 165
MACON, GA 31201-2168
Phone number: 478-633-1634