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Individual

CARMEN JAGOLINO DELA CRUZ-PLACER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
815 HICKORY RIDGE RD SW, LILBURN, GA 30047-3159
(770) 381-0125
Mailing address
815 HICKORY RIDGE RD SW, LILBURN, GA 30047-3159
(770) 381-0125

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN152159
GA

Other

Enumeration date
06/30/2006
Last updated
07/08/2007
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