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Individual

MRS. KALIA C LUCAS SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
405 KENDRICK TER SW, ATLANTA, GA 30331-9109
(404) 839-2107
Mailing address
405 KENDRICK TER SW, ATLANTA, GA 30331-9109
(404) 839-2107

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN088422
GA

Other

Enumeration date
11/29/2023
Last updated
11/29/2023
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