Sheree Blair-Larry

Individual provider Active NPI Contractor · Conyers, GA

NPI 1194435289 · NPPES record last updated Nov 29, 2022

Key facts

NPI
1194435289
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
Practice address
1215 River Rush LN NE
Conyers, GA 30012-6614
Phone
(470) 655-6492
NPI assigned
Nov 29, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
171W00000X Yes

Addresses

Primary practice location

1215 River Rush LN NE
Conyers, GA 30012-6614

Mailing address

1215 River Rush LN NE
Conyers, GA 30012-6614
Phone (470) 655-6492

Electronic endpoints

TypeEndpointUseAffiliation
Other URL saslovingcare,com Health Information Exchange (HIE)

Other providers in Conyers, GA

All providers in Conyers, GA · Contractor in Georgia

Sources for this page

Verify at the official NPI Registry.