Individual
JAYLEN LEANDRE HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
579 SIMONTON OAK LN, LAWRENCEVILLE, GA 30045-3525
(317) 476-1877
Mailing address
579 SIMONTON OAK LN, LAWRENCEVILLE, GA 30045-3525
(317) 476-1877
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
060490575
GA
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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