Search › Georgia › 363LF0000X
Modupeola Brisibe
NPI 1376993519 · on the registry since 2016 · sole proprietor
Practice
- Address
- 280 Cobb Pkwy S Ste 60
Marietta, GA 30060 - Phone
- (888) 663-6331
- Fax
- (415) 252-7176
- Clinicians at this address
- 3
Additional practice sites
- 100 Piedmont Rd, Marietta, GA
Registry record
- Primary taxonomy
- 363LF0000X
363LF0000X
- Also registered as
- 363LF0000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-04-17
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