Provider Demographics
NPI:1659470094
Name:FANTZ, CORINNE RENEE (PHD)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:RENEE
Last Name:FANTZ
Suffix:
Gender:F
Credentials:PHD
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Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:CRAWFORD LONG HOSPITAL, DAVIS FISCHER BLDG
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2247
Mailing Address - Country:US
Mailing Address - Phone:404-686-1913
Mailing Address - Fax:404-712-4780
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:CRAWFORD LONG HOSPITAL, DAVIS FISCHER BLDG
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-686-1913
Practice Address - Fax:404-712-4780
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QC1000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyChemistry