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Organization
LISA CZECH LLC
Active
Organization
LISA CZECH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA CZECH (SPEECH-LANGUAGE PATHOLOGIST)
(678) 428-8969
Entity
Organization
Contact information
Practice address
388 GLENN CIR, DECATUR, GA 30030-1929
(678) 428-8969
Mailing address
388 GLENN CIR, DECATUR, GA 30030-1929
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004766
GA
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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