Individual
DR. ELAYNE F. THERIAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5040 BAINBRIDGE CT SW, LILBURN, GA 30047-7305
(404) 218-8494
(770) 925-8677
Mailing address
5040 BAINBRIDGE CT SW, LILBURN, GA 30047-7305
(404) 218-8494
(770) 925-8677
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
028328
GA
Other
Enumeration date
11/13/2008
Last updated
11/13/2008
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