Registry details
Type
Individual
Primary specialty
Physician Assistant, Surgical
Enumerated
Jul 18, 2018
License(s)
8877 (GA), 8877 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1371 CHURCH STREET EXT NE STE 200 | Marietta, GA 30060-7913 | 678-344-8900 |
| MAILING | 1551 JANMAR RD | Snellville, GA 30078-5606 | 678-344-8900 |
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