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1609212661
LARESA M WOODARD
EAST POINT, GA
NPI
1609212661
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Former Name
LARESA M NOLTON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: GA 06771)
Enumeration Date
2013-05-17
Last Update Date
2013-05-17
Business Address
Mrs. LARESA M WOODARD PA-C
1422 CLEVELAND AVE
EAST POINT, GA 30344-6983
Phone number: 404-766-3337
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Mailing Address
Mrs. LARESA M WOODARD PA-C
10 PERIMETER PARK DR APT 343
ATLANTA, GA 30341-1344
Phone number: 404-556-8906
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