Individual
LAQUISHA REESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
948 TYRELL DR, AUSTELL, GA 30106-1552
(678) 315-3626
Mailing address
948 TYRELL DR, AUSTELL, GA 30106-1552
(678) 315-3626
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
415207301
GA
Other
Enumeration date
05/08/2026
Last updated
05/08/2026
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