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Individual

LANCINE CISSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5621 GRANDE RIVER RD, ATLANTA, GA 30349-9126
(217) 607-6243
Mailing address
5621 GRANDE RIVER RD, ATLANTA, GA 30349-9126
(217) 607-6243

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
CJP1942
GA

Other

Enumeration date
10/04/2025
Last updated
10/04/2025
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