Most Relevant Information
Provider Data
| NPI Number: | 1003596107 |
| Provider Name: | AMELIA CATHERINE LLERENA |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/24/2023 |
| Last Updated: | 06/14/2024 |
Provider Practice Location
777 HEMLOCK ST
MACON
GA
312012102
Practice Location Phone/Fax
| Phone: | 4786336701 |
| Fax: |
Provider Mailing Location
764 PINE ST
MACON
GA
312012107
Provider Mailing Phone/Fax
| Phone: | 4786331056 |
| Fax: |