NPI 1770859563

Vanessa King, CSTCPCA

Practitioner Contractor Fayetteville, GA

Practice location

Address: 145 Forest Hall Ln, Fayetteville, GA 30214-4025
Phone: (770) 987-9228
Fax: (770) 629-2380
Mailing address: PO Box 142765, Fayetteville, GA 30214-6520

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X

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Registry record

NPI: 1770859563
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Mar 2012
Record last updated: 27 Mar 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.