Provider Demographics
NPI:1104650647
Name:LNU, VEDSHRAMI
Entity type:Individual
Prefix:
First Name:VEDSHRAMI
Middle Name:
Last Name:LNU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1197 CHARLIE LN SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-4203
Mailing Address - Country:US
Mailing Address - Phone:706-572-5916
Mailing Address - Fax:
Practice Address - Street 1:331 ROCKBRIDGE RD NW STE 800
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-6105
Practice Address - Country:US
Practice Address - Phone:706-572-5916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
GAMT011984225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No175F00000XOther Service ProvidersNaturopath