Individual
LYDIA LEE KINGRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3490 DENHAM RD, SYCAMORE, GA 31790-3306
(229) 392-4976
Mailing address
3490 DENHAM RD, SYCAMORE, GA 31790-3306
(229) 392-4976
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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