Individual
MISS LAURA ELLEN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1120 15TH ST, EC 3304, AUGUSTA, GA 30912-0004
(706) 721-4409
(706) 721-3990
Mailing address
1120 15TH ST, EC 3304, AUGUSTA, GA 30912-0004
(706) 721-4409
(706) 721-3990
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002039
GA
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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