Individual
LAQUISH DENISE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
244 PEAVY AVE, UNADILLA, GA 31091
(404) 917-7560
Mailing address
2725 HAMILTON MILL RD STE 500, BUFORD, GA 30519-6010
(404) 917-7560
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
08/26/2022
Last updated
08/26/2022
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