Provider Demographics
NPI:1295054450
Name:GRIER, LORRIE E
Entity type:Individual
Prefix:MS
First Name:LORRIE
Middle Name:E
Last Name:GRIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 WESTRIDGE PKWY
Mailing Address - Street 2:102
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-3049
Mailing Address - Country:US
Mailing Address - Phone:770-957-3103
Mailing Address - Fax:770-957-3141
Practice Address - Street 1:155 WESTRIDGE PKWY
Practice Address - Street 2:103
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3049
Practice Address - Country:US
Practice Address - Phone:770-957-3103
Practice Address - Fax:770-957-3141
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10113997291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory