Individual
LAKESHA M CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
153 HILL LN, ELLENWOOD, GA 30294-2805
(770) 453-2045
Mailing address
153 HILL LN, ELLENWOOD, GA 30294-2805
(770) 453-2045
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
246RP1900X
Phlebotomy Technician
—
—
253Z00000X
In Home Supportive Care Agency
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
305S00000X
Point of Service
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
12/26/2023
Last updated
01/10/2024
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