Individual
PAYTON HUNTER LACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AUD
Contact information
Practice address
1051 PARKSIDE CMNS STE 103, GREENSBORO, GA 30642-4517
(706) 623-4425
Mailing address
1051 PARKSIDE CMNS STE 103, GREENSBORO, GA 30642-4517
(706) 623-4425
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AUD004368
GA
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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