DERRICK K STATEN

MABLETON, GA
NPI1891540555
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy343900000X Non-emergency Medical Transport (VAN)
(Licence: GA  24064864)
Enumeration Date2024-04-17
Last Update Date2024-04-17
Business Address
DERRICK K STATEN
518 MOUNT GERIZIM RD SE
MABLETON, GA 30126-6410
Phone number: 470-654-2331
Mailing Address
DERRICK K STATEN
518 MOUNT GERIZIM RD SE
MABLETON, GA 30126-6410
Phone number: 470-654-2331