Search › Georgia › 363L00000X
Virginia Lake
NPI 1720738867 · on the registry since 2022 · sole proprietor
Practice
- Address
- 812 Thornton Pl
Dalton, GA 30720 - Phone
- (404) 578-7393
Registry record
- Primary taxonomy
- 363L00000X
363L00000X
- Also registered as
- 163W00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-03-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia