IDALID LARA

BUFORD, GA
NPI1063238533
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2024-11-29
Last Update Date2024-11-29
Business Address
IDALID LARA
3516 MARION CT
BUFORD, GA 30519-4059
Phone number: 470-546-2090
Mailing Address
IDALID LARA
3516 MARION CT
BUFORD, GA 30519-4059
Phone number:
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