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1174565022
LAURA P BUSH
FAYETTEVILLE, GA
NPI
1174565022
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: GA 36378)
Enumeration Date
2006-06-12
Last Update Date
2019-03-15
Business Address
LAURA P BUSH P.A.
450 LANIER AVE WEST
FAYETTEVILLE, GA 30214
Phone number: 770-460-8988
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Mailing Address
LAURA P BUSH P.A.
450 LANIER AVE WEST
FAYETTEVILLE, GA 30214
Phone number: 770-460-8988
Copy
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