Jody Amazon PC
in Snellville, GA. Organization (NPI-2).
NPI number1396334330
StatusActive
Last updated in NPPESJan 14, 2021
Details
- NPI
- 1396334330
- Entity type
- Organization (NPI-2)
- Legal business name
- Jody Amazon PC
- Organization subpart
- No
- Enumeration date
- Jan 14, 2021
- Certification date
- Jan 14, 2021
- Last updated
- Jan 14, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0805X | – | – | Yes |
Other names
- Ahava Healthcare (Doing Business As)
Practice location
2160 Fountain Dr Ste 220Snellville, GA 30078-7022
Phone 678-336-9102 · Fax 770-674-8563
Mailing address
2160 Fountain Dr Ste 220Snellville, GA 30078-7022
Phone 678-336-9102 · Fax 770-674-8563
Authorized official
Jordyn Isabel Andrews
Practice Manager
6783369102
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