Individual
MR. LAZERO D ENEYDO VILLAFRANCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CST
Contact information
Practice address
622 PENNYLAKE LANE, STONEMOUNTAIN, GA 30087-5768
(770) 761-9508
Mailing address
PO BOX 839, STONEMOUNTAIN, GA 30086
(770) 761-9508
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
01/18/2008
Last updated
01/18/2008
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