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General NPI Number Information
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NPI Number | 1356297535
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Entity Type | Individual
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Provider Name | LISA DECKER
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Gender | Female
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 9528 US HWY 19 N
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City | ZEBULON
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State | GA
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Zip | 30295
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Country | US
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Telephone | 770-567-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 604 NEW SALEM RD
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City | GRIFFIN
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State | GA
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Zip | 30223-6140
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number |
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License Number State |
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