Individual
REVONIA LYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4630 ROLLING BROOK CT, UNION CITY, GA 30291-6524
(678) 507-4926
Mailing address
4630 ROLLING BROOK CT, UNION CITY, GA 30291-6524
(678) 507-4926
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
GA
246RP1900X
Phlebotomy Technician
—
—
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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