Individual
LOIS VANESSA KNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
752 SPENCER RD, DIXIE, GA 31629-3533
(229) 375-8548
Mailing address
752 SPENCER RD, DIXIE, GA 31629-3533
(229) 375-8548
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
852059343
—
GA
Enumeration date
12/07/2020
Last updated
12/07/2020
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