Individual
MRS. JENNIFER LEE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4484 PEACHTREE RD NE, ATLANTA, GA 30319-2737
(404) 364-8486
Mailing address
119 GREENFIELD WAY, NEWNAN, GA 30263
(678) 416-6146
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
AT001295
GA
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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