Individual
MIGUEL LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3300 NORTHEAST EXPY NE BLDG 7, ATLANTA, GA 30341-3938
(404) 695-0369
Mailing address
3300 NORTHEAST EXPY NE BLDG 7, ATLANTA, GA 30341-3938
(770) 235-5698
(972) 996-6675
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
GA
Other
Enumeration date
05/01/2014
Last updated
05/01/2014
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