Lw Gwinnett County Radiation
NPI #1104091602 in Lawrenceville, Georgia
Provider Information
- NPI Number
- 1104091602
- Entity Type
- Organization
- Organization Name
- Lw Gwinnett County Radiation
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- RADIOTHERAPY CLINICS OF GEORGIA,LLC
- Primary Specialty
- Specialist
- Enumeration Date
- Apr 25, 2008
- Last Updated
- Apr 25, 2008
Practice Location
- Address
- 311 PHILIP BLVD
- City
- Lawrenceville
- State
- Georgia
- ZIP Code
- 30045-8733
- Phone
- (770) 995-3000
Authorized Official
- Name
- TAMMIE LAVISCOUNT
- Title
- CONTRACT ANALYST
- Phone
- (770) 682-2080
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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