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Individual

LORESE R GARFIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
290 WISTERIA WAY, COVINGTON, GA 30016-7243
(404) 702-7871
Mailing address
290 WISTERIA WAY, COVINGTON, GA 30016-7243
(404) 702-7871

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
GA

Other

Enumeration date
10/02/2018
Last updated
10/02/2018
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