Most Relevant Information
Provider Data
| NPI Number: | 1003510108 |
| Provider Name: | WILERMINA LACROIX |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/30/2023 |
| Last Updated: | 03/30/2023 |
Provider Practice Location
9529 S MAIN ST
JONESBORO
GA
302368708
Practice Location Phone/Fax
| Phone: | 6316398860 |
| Fax: |
Provider Mailing Location
9529 S MAIN ST
JONESBORO
GA
302368708
Provider Mailing Phone/Fax
| Phone: | 6316398860 |
| Fax: |