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1609376763
LIAM SAMUEL GROSECLOSE
AUSTELL, GA
NPI
1609376763
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA RN223393)
Enumeration Date
2018-02-15
Last Update Date
2020-11-04
Business Address
LIAM SAMUEL GROSECLOSE
1700 MULKEY RD
AUSTELL, GA 30106-1116
Phone number: 770-941-5750
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Mailing Address
LIAM SAMUEL GROSECLOSE
3576 S SHERWOOD RD SE
SMYRNA, GA 30082-2832
Phone number: 678-522-1963
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