Organization
ZA1603 LC
Active
Parent organization
ZA1603 LC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ZA1603 LC
Authorized official
DASHNA LOUIS-CHARLES (CLINICIAN SPECIALIST)
(470) 486-9860
Entity
Organization
Contact information
Practice address
1824 HERRINGBONE HOLW, LITHONIA, GA 30058-5516
(470) 486-9860
Mailing address
1824 HERRINGBONE HOLW, LITHONIA, GA 30058-5516
(470) 486-9860
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
11/14/2025
Last updated
11/14/2025
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