Individual
MRS. LARESA M WOODARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1422 CLEVELAND AVE, EAST POINT, GA 30344-6983
(404) 766-3337
(404) 766-1464
Mailing address
10 PERIMETER PARK DR APT 343, ATLANTA, GA 30341-1344
(404) 556-8906
(610) 980-3473
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
06771
GA
Other
Enumeration date
05/17/2013
Last updated
05/17/2013
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