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1821623232
JACK ANTHONY MICELI
ROME, GA
NPI
1821623232
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: GA RN242971)
Enumeration Date
2020-03-05
Last Update Date
2023-10-24
Business Address
JACK ANTHONY MICELI NP-C
1825 MARTHA BERRY BLVD NW
ROME, GA 30165-1625
Phone number: 762-235-1470
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Mailing Address
JACK ANTHONY MICELI NP-C
221 TECHNOLOGY PKWY NW
ROME, GA 30165-1369
Phone number: 762-235-1000
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