Individual
ANTIONETE LASHA IRVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
519 SNOWFALL TER, PALMETTO, GA 30268-1401
(404) 749-0952
Mailing address
519 SNOWFALL TER, PALMETTO, GA 30268-1401
(404) 749-0952
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
GA
Other
Enumeration date
03/19/2025
Last updated
03/19/2025
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