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1548736630
KEISHANNA BERNAE' ANTHONY
VALDOSTA, GA
NPI
1548736630
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171W00000X Contractor
(Licence: GA 056311378)
Enumeration Date
2018-10-16
Last Update Date
2018-10-16
Business Address
Mrs. KEISHANNA BERNAE' ANTHONY BA, PP
1463 JONES AVE
VALDOSTA, GA 31601-4294
Phone number: 770-354-2382
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Mailing Address
Mrs. KEISHANNA BERNAE' ANTHONY BA, PP
1463 JONES AVE
VALDOSTA, GA 31601-4294
Phone number: 770-354-2382
Copy
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