Individual
TISHANA EASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5530 WINDWARD PKWY STE 119, ALPHARETTA, GA 30004-8969
(910) 546-6984
Mailing address
5530 WINDWARD PKWY STE 119, ALPHARETTA, GA 30004-8969
(910) 546-6984
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO132857
GA
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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