Individual
LANNY BRIAN LIGHTFOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
2098 TERON TRCE STE 300, DACULA, GA 30019-1667
(770) 614-4060
Mailing address
2098 TERON TRCE STE 300, DACULA, GA 30019-1667
(770) 614-4060
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001451
GA
Other
Enumeration date
12/30/2007
Last updated
12/30/2007
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