Individual
MS. MARY LILES BOOKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,BSN,MSN
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
(404) 417-2936
Mailing address
3939 LAVISTA RD STE E, #187, TUCKER, GA 30084-5162
(404) 321-6111
(404) 417-2936
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R040703
GA
Other
Enumeration date
06/23/2006
Last updated
07/08/2007
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