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1922136290
LAURIE L TIS
ATLANTA, GA
NPI
1922136290
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: GA AT000346)
Enumeration Date
2007-03-01
Last Update Date
2007-07-08
Business Address
LAURIE L TIS ATC
125 DECATUR STREET STE 137
ATLANTA, GA 30303
Phone number: 404-651-4022
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Mailing Address
LAURIE L TIS ATC
PO BOX 3975
ATLANTA, GA 30302-3975
Phone number: 404-651-4022
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