Individual
LISA TANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2781 LAVISTA RD, DECATUR, GA 30033-1713
(404) 929-1013
(404) 929-1028
Mailing address
2781 LAVISTA RD, DECATUR, GA 30033-1713
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH023564
GA
Other
Enumeration date
09/27/2011
Last updated
09/27/2011
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