Individual
BIANCA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR LOSS SPECIALIST
Contact information
Practice address
4654 RUBY FORREST DR, STONE MOUNTAIN, GA 30083-4945
(404) 309-4366
Mailing address
4654 RUBY FORREST DR, STONE MOUNTAIN, GA 30083-4945
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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