Individual
MS. SUSAN MARY SYSOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 PROFESSIONAL DR, LAWRENCEVILLE, GA 30548
(678) 312-3000
Mailing address
6605 FIRELIGHT LN, FLOWERY BRANCH, GA 30542-3887
(770) 375-9430
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
OTA000266
GA
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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