Individual
LAN VU-WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
450 N CANDLER ST, DECATUR, GA 30030-2626
(404) 501-6769
Mailing address
718 TEANECK RD, TEANECK, NJ 07666-4245
(201) 833-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00437500
NJ
363AM0700X
Medical Physician Assistant
Primary
11560
GA
363AM0700X
Medical Physician Assistant
PA5498
MA
Other
Enumeration date
09/03/2015
Last updated
10/22/2024
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