Individual
MIECHA Y WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1487 HIGHWAY 92 N, FAYETTEVILLE, GA 30214-3323
(404) 944-3031
Mailing address
1415 HIGHWAY 85 N # 310-178, FAYETTEVILLE, GA 30214-7738
(404) 944-3031
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
11/27/2023
Last updated
11/27/2023
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