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Individual

MR. ROY HALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
859 SHADOW LAKE DR, STE 100, LITHONIA, GA 30058-3226
(770) 498-8644
Mailing address
859 SADDLE LAKE DR, 859 SADDLE LAKE DR, LITHONIA, GA 30058-3226
(770) 498-8644

Taxonomy

Speciality
Code
Description
License number
State
372500000X
Chore Provider
372600000X
Adult Companion
Primary

Other

Enumeration date
07/02/2009
Last updated
07/02/2009
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