Individual
TINA LE TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
413 LAKEVIEW WAY, LAGRANGE, GA 30241-8792
(404) 647-3051
Mailing address
413 LAKEVIEW WAY, LAGRANGE, GA 30241-8792
(404) 647-3051
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12106
GA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/28/2022
Last updated
04/12/2024
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