Individual
MRS. ELIZABETH ANNE LYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
150 HOSPITAL CIR, CANTON, GA 30114-3209
(770) 479-5648
Mailing address
4684 NORMAN DR NW, KENNESAW, GA 30144-1332
(770) 924-9447
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001281
GA
Other
Enumeration date
02/28/2012
Last updated
02/28/2012
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