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1598150195
KIRBY BANDOQUILLO
MARIETTA, GA
NPI
1598150195
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA RN221793)
Enumeration Date
2015-03-31
Last Update Date
2022-07-06
Business Address
KIRBY BANDOQUILLO NP
61 WHITCHER ST NE STE 3110
MARIETTA, GA 30060-1179
Phone number: 770-422-2326
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Mailing Address
KIRBY BANDOQUILLO NP
100 STONEFOREST DR STE 130
WOODSTOCK, GA 30189-4881
Phone number: 678-388-1621
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