Healthcare Provider Details

I. General information

NPI: 1407361918
Provider Name (Legal Business Name): COMEIKA TOWANNA NORWOOD-SPRINKLE RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: COMEIKA TOWANNA NORWOOD-SPRINKLE RRT

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 12/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3073 PANTHERSVILLE RD
DECATUR GA
30034-3828
US

IV. Provider business mailing address

55 REGENCY PL
COVINGTON GA
30016-4576
US

V. Phone/Fax

Practice location:
  • Phone: 404-243-2100
  • Fax:
Mailing address:
  • Phone: 404-421-3076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number006423
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: