JACK ANTHONY MICELI

ROME, GA
NPI1821623232
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: GA  RN242971)
Enumeration Date2020-03-05
Last Update Date2023-10-24
Business Address
JACK ANTHONY MICELI NP-C
1825 MARTHA BERRY BLVD NW
ROME, GA 30165-1625
Phone number: 762-235-1470
Mailing Address
JACK ANTHONY MICELI NP-C
221 TECHNOLOGY PKWY NW
ROME, GA 30165-1369
Phone number: 762-235-1000