Individual
LAURA P BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
450 LANIER AVE WEST, FAYETTEVILLE, GA 30214
(770) 460-8988
(770) 460-0727
Mailing address
450 LANIER AVE WEST, FAYETTEVILLE, GA 30214
(770) 460-8988
(770) 460-0727
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
36378
GA
Other
Enumeration date
06/12/2006
Last updated
03/15/2019
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