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1083107718
PO EL PARK
MARIETTA, GA
NPI
1083107718
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
Enumeration Date
2018-06-07
Last Update Date
2022-07-06
Business Address
PO EL PARK PA
61 WHITCHER ST NE STE 2100
MARIETTA, GA 30060-1179
Phone number: 770-423-0595
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Mailing Address
PO EL PARK PA
100 STONEFOREST DR STE 130
WOODSTOCK, GA 30189-4881
Phone number: 678-388-1621
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