Most Relevant Information
Provider Data
| NPI Number: | 1003674862 |
| Provider Name: | JASMIN COPELAND INTERN |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/07/2024 |
| Last Updated: | 03/07/2024 |
Provider Practice Location
5415 SUGARLOAF PKWY STE 2208
LAWRENCEVILLE
GA
300437832
Practice Location Phone/Fax
| Phone: | 7706760737 |
| Fax: |
Provider Mailing Location
5415 SUGARLOAF PKWY STE 2208
LAWRENCEVILLE
GA
300437832
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |