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Individual

MR. JAMIL R LEA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
289 BRYSON LAKE CIR, DOUGLASVILLE, GA 30134-5920
(678) 683-5506
Mailing address
289 BRYSON LAKE CIR, DOUGLASVILLE, GA 30134-5920

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
11207050089
GA

Other

Enumeration date
02/10/2022
Last updated
02/10/2022
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