Organization
GEORGIA CANCER SPEC LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA HOLDEN ACCOUNTING (LEAD)
(404) 943-0205
Entity
Organization
Contact information
Practice address
1364 WELLBROOK CIR NE, CONYERS, GA 30012-3872
(404) 943-0205
Mailing address
PO BOX 468329, ATLANTA, GA 31146-8329
(404) 943-0205
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
—
Other
Enumeration date
03/06/2007
Last updated
08/22/2020
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