Individual
MICHELE DIANE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
935A JAMERSON RD, MARIETTA, GA 30066-1097
(770) 516-2734
Mailing address
935A JAMERSON RD, MARIETTA, GA 30066-1097
(770) 516-2734
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO001865
GA
Other
Enumeration date
05/06/2008
Last updated
05/06/2008
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