Individual
TRACY DESOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4813 RIDGE RD STE 113, DOUGLASVILLE, GA 30134-6120
(678) 722-5778
Mailing address
4813 RIDGE RD STE 113, DOUGLASVILLE, GA 30134-6120
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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