Individual
DURMOND LAVELL GLANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
505 ROLAND MANOR DR, DACULA, GA 30019-6584
(470) 361-9936
Mailing address
505 ROLAND MANOR DR, DACULA, GA 30019-6584
(470) 361-9936
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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