Individual
TACCARA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 LESLIE OAKS DR APT 10107, LITHONIA, GA 30058-6741
(404) 301-8803
Mailing address
8170 MALL PKWY # 1056, LITHONIA, GA 30038-2545
(404) 301-8803
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
—
—
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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