Individual
MS. LISA MARIE ANTHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
400 ARNOLD MILL RD, WOODSTOCK, GA 30188
(404) 210-3300
Mailing address
400 ARNOLD MILL RD, WOODSTOCK, GA 30188-2834
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
9437361-4810
GA
Other
Enumeration date
04/06/2018
Last updated
07/12/2018
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