Healthcare Provider Details

I. General information

NPI: 1891994745
Provider Name (Legal Business Name): MS. FAY A LAING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 KIRKLAND RD
COVINGTON GA
30016-3316
US

IV. Provider business mailing address

660 KIRKLAND RD
COVINGTON GA
30016
US

V. Phone/Fax

Practice location:
  • Phone: 678-625-7730
  • Fax: 678-625-8042
Mailing address:
  • Phone: 678-625-7730
  • Fax: 678-625-8042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: