Individual
LORETTA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 323-0174
(706) 256-3264
Mailing address
403 WHITESVILLE ST, LAGRANGE, GA 30240-5335
(706) 616-5695
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
117268
GA
Other
Enumeration date
08/09/2011
Last updated
08/09/2011
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