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1932940541
CHRISTINE SUTANTO
AUGUSTA, GA
NPI
1932940541
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: GA 16476)
Enumeration Date
2024-06-06
Last Update Date
2024-06-06
Business Address
CHRISTINE SUTANTO
1459 LANEY WALKER BLVD
AUGUSTA, GA 30912-0002
Phone number: 706-721-7005
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Mailing Address
CHRISTINE SUTANTO
636 11TH ST APT 2109
AUGUSTA, GA 30901-2186
Phone number: 213-369-0199
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