Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Jan 11, 2018
License(s)
160430 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 685 PAPER CREEK DR | Lawrenceville, GA 30046-5328 | 678-891-7332 |
| LOCATION | 2801 DEKALB MEDICAL PKWY | Lithonia, GA 30058-4996 | 404-501-8460 |
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