Individual
MS. ALBERTA CANADY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A,
Contact information
Practice address
1670 CLAIRMONT RD, 111B, DECATUR, GA 30033-4004
(404) 321-6111
(404) 329-2211
Mailing address
3698 EMBRY CIR, ATLANTA, GA 30341-4355
(770) 455-1385
(770) 455-8016
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
615
GA
Other
Enumeration date
07/03/2006
Last updated
07/08/2007
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