Individual
CARSON HUERTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 N LEWIS ST, LAGRANGE, GA 30240-2738
(706) 302-0299
Mailing address
200 N LEWIS ST, LAGRANGE, GA 30240-2738
(706) 302-0299
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PCET004281
GA
Other
Enumeration date
08/26/2025
Last updated
08/26/2025
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