Search › Georgia › 364SH0200X
Ken Ibeto
NPI 1053807347 · on the registry since 2018
Practice
- Address
- 7646 Forest Glen Way
Lithia Springs, GA 30122 - Phone
- (678) 637-6249
- Fax
- (404) 393-4950
Registry record
- Primary taxonomy
- 364SH0200X
364SH0200X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-07-10
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