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1720617756
CORWIN OSWALD DEMATTOS
GRAYSON, GA
NPI
1720617756
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA 189365)
Enumeration Date
2020-04-02
Last Update Date
2021-12-02
Business Address
CORWIN OSWALD DEMATTOS
1637 ATLANTA HWY SUITE A
GRAYSON, GA 30017-3001
Phone number: 678-344-8268
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Mailing Address
CORWIN OSWALD DEMATTOS
1637 ATLANTA HWY SUITE A
GRAYSON, GA 30017-5942
Phone number: 678-344-8268
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