Individual
LISA SMART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DRIVER/OWNER
Contact information
Practice address
560 STAGE COACH RD LOT 1, PELHAM, GA 31779-4072
(229) 319-8815
(229) 683-3748
Mailing address
560 STAGE COACH RD LOT 1, PELHAM, GA 31779-4072
(229) 319-8815
(229) 683-3748
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
01/10/2022
Last updated
01/10/2022
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