Provider Demographics
NPI:1306177746
Name:FRANK, MARA BROWNSMITH (LAC)
Entity Type:Individual
Prefix:MISS
First Name:MARA
Middle Name:BROWNSMITH
Last Name:FRANK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 SHIREWOOD PARK
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1159
Mailing Address - Country:US
Mailing Address - Phone:770-756-1979
Mailing Address - Fax:
Practice Address - Street 1:118 SHIREWOOD PARK
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1159
Practice Address - Country:US
Practice Address - Phone:770-756-1979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13267171100000X
GA322171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist