Individual
MIA GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1701 HARDEE AVE, FORT MCPHERSON, GA 30330
(404) 464-0268
(404) 464-0249
Mailing address
630 IRONSTONE DRIVE, FAIRBURN, GA 30213
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN061651
GA
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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