Individual
KEITH ISAAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2124 CHASE DR, LOGANVILLE, GA 30052-7205
(404) 754-9499
Mailing address
2124 CHASE DR, LOGANVILLE, GA 30052-7205
(404) 754-9499
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/07/2026
Last updated
01/21/2026
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