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Individual

ALVARO LIEVANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3109 BRANDY STA SE, ATLANTA, GA 30339-4407
(770) 438-7575
Mailing address
3109 BRANDY STA SE, ATLANTA, GA 30339-4407
(770) 438-7575
(770) 438-7514

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14775
GA

Other

Enumeration date
08/21/2012
Last updated
08/21/2012
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