Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Jun 20, 2022
License(s)
12425 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 720 WESTVIEW DR SW | Atlanta, GA 30310-1458 | 404-756-1959 |
| MAILING | 2162 CAPELLA CIR SW | Atlanta, GA 30331-3867 |
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