Individual
LIS KAVJIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1756 ELLEN ST NW, ATLANTA, GA 30318-2712
(703) 582-5641
Mailing address
1756 ELLEN ST NW, ATLANTA, GA 30318-2712
(703) 582-5641
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002281
GA
Other
Enumeration date
03/20/2014
Last updated
03/20/2014
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