Individual
LACI REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
10 LAVERNE CT SE, SILVER CREEK, GA 30173-2417
(706) 767-6188
Mailing address
10 LAVERNE CT SE, SILVER CREEK, GA 30173-2417
(706) 767-6188
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
1146350
GA
Other
Enumeration date
07/28/2025
Last updated
07/28/2025
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