Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 71718 | GA |
NPI | 1205152154 |
---|---|
Provider Name | Dr. Jennifer Lanzer |
First Address | Atlanta, GA 30322 |
Second Address | Atlanta, GA 30322-1059 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2010 |
Last Update Date | 24/04/2014 |