Individual
MRS. LAURA DIVOKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1404 RIVER PL STE 501, BRASELTON, GA 30517-5600
(770) 534-2020
(770) 534-8025
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
080814
GA
Other
Enumeration date
04/15/2011
Last updated
11/09/2020
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