Individual
MARCIA MAHONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2899 FIVE FORKS TRICKUM RD, LAWRENCEVILLE, GA 30044-5803
(770) 633-9213
Mailing address
175 CHANDLER RIDGE LN, LAWRENCEVILLE, GA 30045-6524
(404) 915-4639
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
OTA000845
GA
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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