Individual provider · NPI-1

Theo Lanier III

Home Health Aide · Mableton, GA

NPI number1447966429
StatusActive
Last updated in NPPESJan 24, 2023

Details

NPI
1447966429
Entity type
Individual (NPI-1)
Name
Theo Lanier III
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 24, 2023
Certification date
Jan 24, 2023
Last updated
Jan 24, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
374U00000X Home Health Aide––Yes

Practice location

5343 Concordia Pl Se
Mableton, GA 30126-2971

Phone 404-482-6939

Mailing address

5343 Concordia Pl Se
Mableton, GA 30126-2971

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