Provider Demographics
NPI:1093201295
Name:FEW, JOI
Entity Type:Individual
Prefix:
First Name:JOI
Middle Name:
Last Name:FEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6994 MISTTOP LOOP
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-3060
Mailing Address - Country:US
Mailing Address - Phone:404-960-9285
Mailing Address - Fax:
Practice Address - Street 1:6994 MISTTOP LOOP
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-3060
Practice Address - Country:US
Practice Address - Phone:404-960-9285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058111261171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor