Individual
NADIR HAZLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2197 N LAKE PARK DRIVE, SMYRNA, GA 30080-7698
(330) 461-7929
Mailing address
2197 N LAKE PARK DRIVE, SMYRNA, GA 30080-7698
(330) 461-7929
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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