Idesta Ralph
NPI #1205235371 in College Park, Georgia
Provider Information
- NPI Number
- 1205235371
- Entity Type
- Individual
- Name
- Idesta Ralph
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Technician, Pathology - Phlebotomy
- Enumeration Date
- Aug 14, 2014
- Last Updated
- Oct 16, 2024
Practice Location
- Address
- 5530 OLD NATIONAL HWY BLDG 5530-B2
- City
- College Park
- State
- Georgia
- ZIP Code
- 30349-3356
- Phone
- (470) 818-2264
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician, Pathology - Phlebotomy — Phlebotomy |
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