Most Relevant Information
Provider Data
| NPI Number: | 1003555830 |
| Provider Name: | GREGORY EDWARD NIZNIK |
| Entity Type: | Individual |
| Taxonomy Code: | 156F00000X |
| Specialty: | Technician/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/31/2022 |
| Last Updated: | 05/31/2022 |
Provider Practice Location
1416 CLARINBRIDGE PKWY NW
KENNESAW
GA
301446669
Practice Location Phone/Fax
| Phone: | 4042950052 |
| Fax: |
Provider Mailing Location
1416 CLARINBRIDGE PKWY NW
KENNESAW
GA
301446669
Provider Mailing Phone/Fax
| Phone: | 4042950052 |
| Fax: |