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Tawanna Easley, COSMETOLOGIST
Prosthetic/Orthotic Supplier in College Park, Georgia
NPI 1073392130

Tawanna Easley is a Prosthetic/Orthotic Supplier based in College Park, GA. Tawanna Easley practices in College Park, GA and has the professional credentials of COSMETOLOGIST. The NPI Number for Tawanna Easley is 1073392130 and holds a License No. CO093582 (Georgia).

The current practice location address for Tawanna Easley is 2900 Lajean Dr, College Park, GA and can be reached out via phone at 678-437-6348.

Location: 2900 Lajean Dr, College Park, GA, 30349-4148
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073392130
Provider Name
Tawanna Easley
Credential
COSMETOLOGIST
Provider Entity Type
Individual
Gender
Female
Address
2900 Lajean Dr, College Park, GA, 30349-4148
Phone Number
678-437-6348
Fax Number
Provider Enumeration Date
09/27/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2900 Lajean Dr
City
College Park
State
Georgia
Zip
30349-4148
Phone Number
678-437-6348
Fax Number
person
Provider Business Mailing Address Details
Address
2900 Lajean Dr
City
College Park
State
Georgia
Zip
30349-4148
Phone Number
678-437-6348
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
Prosthetics Case Management
Taxonomy
1744P3200X
License No.
CO093582 (Georgia)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
CO093582 (Georgia)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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