Individual
DEONTA LASHEA BLOUNT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
798 RAYS RD STE 100, STONE MOUNTAIN, GA 30083-3144
(470) 736-9644
(404) 549-3151
Mailing address
798 RAYS RD STE 100, STONE MOUNTAIN, GA 30083-3144
(470) 736-9644
(404) 549-3151
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
LPN072168
GA
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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