Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Sep 28, 2006
License(s)
R107241NP (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 4629 CHATSWORTH HIGHWAY 225 NE | Resaca, GA 30735-6536 | 706-629-8750 |
| LOCATION | 1104 PROFESSIONAL BLVD | Dalton, GA 30720-2588 | 706-226-5533 |
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