Individual
ROMA A TAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
1102 CLEVE ST, EAST DUBLIN, GA 31027-3215
(980) 585-5556
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
212621
NC
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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