Individual
SHEREE BLAIR-LARRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 RIVER RUSH LN NE, CONYERS, GA 30012-6614
(470) 655-6492
Mailing address
1215 RIVER RUSH LN NE, CONYERS, GA 30012-6614
(470) 655-6492
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
11/29/2022
Last updated
11/29/2022
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