Individual
KONRAD DEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
229 S DAVIS RD STE 900, LAGRANGE, GA 30241-2609
(470) 686-2225
Mailing address
229 S DAVIS RD STE 900, LAGRANGE, GA 30241-2609
(470) 686-2225
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1219
GA
Other
Enumeration date
04/19/2018
Last updated
04/19/2018
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