Individual
MR. JACK LANSDOWNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1274 AVONDALE AVE SE, ATLANTA, GA 30312-3846
(706) 267-1176
Mailing address
1274 AVONDALE AVE SE, ATLANTA, GA 30312-3846
(706) 267-1176
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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