ICEESHO BETHEL

JACKSON, GA
NPI1619227576
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy332B00000X Durable Medical Equipment & Medical Supplies
(Licence: GA  7058)
Enumeration Date2012-09-18
Last Update Date2012-09-18
Business Address
-- ICEESHO BETHEL RRT
310 HICKORY RD
JACKSON, GA 30233-6271
Phone number: 706-476-4988
Mailing Address
-- ICEESHO BETHEL RRT
310 HICKORY RD
JACKSON, GA 30233-6271
Phone number: 706-476-4988