Individual
BEVERLY CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6016 GEORGETOWN DR APT 73, COLUMBUS, GA 31907-4664
(706) 315-0685
Mailing address
6016 GEORGETOWN DR, COLUMBUS, GA 31907-4697
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
0028837239
GA
Other
Enumeration date
02/06/2025
Last updated
02/06/2025
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