Individual
SIERRA ELEXUS MERCEDES CORNELOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1404 LAWRENCEVILLE SUWANEE RD, LAWRENCEVILLE, GA 30043-4331
(678) 646-1280
Mailing address
1404 LAWRENCEVILLE SUWANEE RD STE 101, LAWRENCEVILLE, GA 30043
(678) 646-1280
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
004886
GA
Other
Enumeration date
06/25/2022
Last updated
06/25/2022
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