Za1603 Lc

NPI #1649130311 in Lithonia, Georgia

Provider Information

NPI Number
1649130311
Entity Type
Organization
Organization Name
Za1603 Lc
Subpart
Yes (part of a larger organization)
Parent Organization
ZA1603 LC
Primary Specialty
Point of Service
Enumeration Date
Nov 14, 2025
Last Updated
Nov 14, 2025

Practice Location

Address
1824 HERRINGBONE HOLW
State
Georgia
ZIP Code
30058-5516
Phone
(470) 486-9860

Authorized Official

Name
DASHNA LOUIS-CHARLES
Title
CLINICIAN SPECIALIST
Phone
(470) 486-9860

Specialties & Taxonomy Codes

Specialty
Point of Service

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