Ebot B Manga

NPI #1164920716 in Dacula, Georgia

Provider Information

NPI Number
1164920716
Entity Type
Individual
Name
Ebot B Manga
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Nurse Practitioner - Family
Enumeration Date
Jan 29, 2018
Last Updated
Jul 20, 2021

Practice Location

Address
2064 LILAC ARBOR WAY
City
Dacula
State
Georgia
ZIP Code
30019-2475
Phone
(678) 887-4367

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner - FamilyFamily

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