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General NPI Number Information
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NPI Number | 1639657778
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Entity Type | Individual
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Provider Name | LAUREN EMBRY LALLI PA
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Gender | Female
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 135 CANAL ST STE 500A
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City | POOLER
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State | GA
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Zip | 31322-4079
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Country | US
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Telephone | 912-335-3876
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Fax |
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Provider Business Mailing Address
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Address Line | 26 POMONA CIR
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City | SAVANNAH
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State | GA
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Zip | 31419-8191
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Country | US
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Telephone | 803-493-6256
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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