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1730322827
REGINA LOUISE ELVIS
LAWRENCEVILLE, GA
NPI
1730322827
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171W00000X Contractor
(Licence: GA MT004268)
Enumeration Date
2009-04-20
Last Update Date
2009-08-22
Business Address
Mrs. REGINA LOUISE ELVIS LMT
271A S CULVER ST
LAWRENCEVILLE, GA 30045-4805
Phone number: 770-676-6383
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Mailing Address
Mrs. REGINA LOUISE ELVIS LMT
647 REBECCA ST
LAWRENCEVILLE, GA 30045-7475
Phone number: 770-378-6666
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