Individual
DR. JUNTIRA LAOTHAVORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1745 PHOENIX BLVD STE 240, ATLANTA, GA 30349-5534
(404) 507-7100
Mailing address
88 N AVONDALE RD # 181, AVONDALE ESTATES, GA 30002-1323
(404) 579-4544
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
076279
GA
2084P0800X
Psychiatry Physician
125061354
IL
Other
Enumeration date
06/25/2012
Last updated
12/04/2020
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