JACKIE DWAYNE ELLINGTON

ELLIJAY, GA
NPI1841540754
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy146M00000X Emergency Medical Technician, Intermediate
(Licence: GA  28696)
Enumeration Date2012-09-18
Last Update Date2012-09-18
Business Address
-- JACKIE DWAYNE ELLINGTON EMT
1548 OLD HWY 5 SOUTH
ELLIJAY, GA 30540
Phone number: 706-273-7477
Mailing Address
-- JACKIE DWAYNE ELLINGTON EMT
PO BOX 1725
ELLIJAY, GA 30540-0033
Phone number: 706-273-7477