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Tabitha Macon

NPI 1316563059 · on the registry since 2020 · sole proprietor

Practice

Address
2045 Dutchess Rd
Lithia Springs, GA 30122
Phone
(770) 356-9703
Organisation at this address
Divine Health And Wellness
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
225700000X
225700000X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2020-06-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia