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1770133936
DEEDGRA ALBERT
STONE MOUNTAIN, GA
NPI
1770133936
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
246RP1900X Technician, Pathology, Phlebotomy
(Licence: GA 48107)
Enumeration Date
2019-09-18
Last Update Date
2019-09-18
Business Address
DEEDGRA ALBERT CPT
4013 CREEK STATION LN
STONE MOUNTAIN, GA 30083-7004
Phone number: 404-246-9098
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Mailing Address
DEEDGRA ALBERT CPT
PO BOX 361134
DECATUR, GA 30036-1134
Phone number: 404-246-9098
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