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Individual

MONICA LANCASTER MOON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1212 E UNION ST, VIENNA, GA 31092-7545
(229) 268-8865
(229) 268-8864
Mailing address
204 N WESTOVER BLVD, ALBANY, GA 31707-2983
(229) 888-6559
(229) 436-4107

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
008049
GA

Other

Enumeration date
08/05/2016
Last updated
01/30/2017
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