Individual
DR. LISA FETHEROLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
44 DARBYS CROSSING DR STE 102A, HIRAM, GA 30141-6040
(770) 439-8393
Mailing address
5672 RIVER OAKS PL NW, ATLANTA, GA 30327-4256
(941) 544-3340
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038.012103
IL
111N00000X
Chiropractor
CH10585
FL
111N00000X
Chiropractor
Primary
CHIRO08946
GA
Other
Enumeration date
03/18/2012
Last updated
03/18/2012
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