Individual
MRS. VANESSA LAQUETTA FREEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
320 DOMINIQUE CT, FAYETTEVILLE, GA 30214-5482
(770) 584-5046
Mailing address
5257 NW TORINO LAKES CIR, PORT ST LUCIE, FL 34986-3238
(404) 769-4234
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
1166762
FL
Other
Enumeration date
10/29/2021
Last updated
10/29/2021
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