Individual
LORA DARRISAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3121 PANTHERSVILLE RD, DECATUR, GA 30034-3830
(404) 270-8193
Mailing address
3121 PANTHERSVILLE RD, DECATUR, GA 30034-3830
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
51924
GA
Other
Enumeration date
06/23/2011
Last updated
06/23/2011
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