Individual
MRS. THERESA RICHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2546 WRANGLER DR SW, ATLANTA, GA 30331-9453
(404) 553-6627
Mailing address
2546 WRANGLER DRIVE, ATLANTA, GA 30331-9453
(404) 553-6627
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN069471
GA
Other
Enumeration date
07/12/2013
Last updated
07/12/2013
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