Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1023457157 |
---|---|
Provider Name | Mandi Rae Call |
First Address | Peachtree City, GA 30269-1055 |
Second Address | Peachtree City, GA 30269-1055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2013 |
Last Update Date | 24/02/2017 |