Greggory Theotis Kent, SFIDC Valid NPI
Individual provider · Military Health Care Provider · Lyons, GA
- NPI
- 1700425568
- Type
- Individual (Type 1)
- Primary specialty
- Military Health Care Provider
- Specialty group
- Other Service Providers
- Taxonomy code
- 171000000X
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2019-12-26
- Last updated
- 2019-12-26
Practice location
223 E Grady Ave
Lyons, GA 30436-1509
(000) 000-0000