Individual
LISHA BLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2938 HERITAGE PL NE, MILLEDGEVILLE, GA 31061-7202
(404) 884-1907
Mailing address
PO BOX 743, MILLEDGEVILLE, GA 31059-0743
(404) 884-1907
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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