Individual
MR. TAN CONG LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
440 PEBBLE CHASE LN, LAWRENCEVILLE, GA 30044-8832
(228) 223-1203
Mailing address
440 PEBBLE CHASE LN, LAWRENCEVILLE, GA 30044-8832
(228) 223-1203
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
227800000X
Certified Respiratory Therapist
—
—
Other
Enumeration date
06/29/2020
Last updated
06/29/2020
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