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1093310021
JOHNATHAN KEITH COLTON JERRIS
SMYRNA, GA
NPI
1093310021
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: GA 10188)
Enumeration Date
2020-11-30
Last Update Date
2021-01-21
Business Address
JOHNATHAN KEITH COLTON JERRIS PA
3903 S COBB DR SE
SMYRNA, GA 30080-8504
Phone number: 770-435-3214
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Mailing Address
JOHNATHAN KEITH COLTON JERRIS PA
914 COLLIER RD NW APT 4002
ATLANTA, GA 30318-2581
Phone number: 706-266-4809
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