Individual
MS. LISLE HAMBRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3100 CLUB DR, LAWRENCEVILLE, GA 30044-2591
(770) 923-3100
(770) 923-1227
Mailing address
3407 HILL POND DR, BUFORD, GA 30519-7329
(678) 714-8981
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT003350
GA
Other
Enumeration date
11/23/2012
Last updated
11/23/2012
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