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DEEDGRA ALBERT CPT

Phlebotomy >> Technician, Pathology >> Technologists, Technicians & Other Technical Service Providers

Registrant NPI Number: 1770133936

Individual Registrant:
 DEEDGRA  ALBERT CPT
Gender: F
Sole Proprietor

Location and contact information for practice:
4013 CREEK STATION LN  STONE MOUNTAIN, GA 30083-7004 US
Tel: 404-246-9098  Fax: --

Contact information for business:
PO BOX 361134  DECATUR, GA 30036-1134 US
Tel: 404-246-9098  Fax: --

Registration Information:
NPI: 1770133936
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y246RP1900XTechnologists, Technicians & Other Technical Service Providers
Technician, Pathology
Phlebotomy
GA48107

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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