Individual
CANDACE M HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2015 MONTREAL RD, TUCKER, GA 30084-5224
(678) 751-2526
Mailing address
2015 MONTREAL RD, TUCKER, GA 30084-5224
(678) 751-2526
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT007107
GA
Other
Enumeration date
05/14/2016
Last updated
05/14/2016
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