LASSINA WILL KOIDIMA

STATESBORO, GA
NPI1710548771
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: GA  RN220878)
Enumeration Date2019-06-21
Last Update Date2021-11-11
Business Address
LASSINA WILL KOIDIMA AGACNP
1635 PONDSIDE DR
STATESBORO, GA 30458-3777
Phone number: 912-507-9077
Mailing Address
LASSINA WILL KOIDIMA AGACNP
1635 PONDSIDE DR
STATESBORO, GA 30458-3777
Phone number: 912-507-9077